RT Journal Article
SR Electronic
T1 General Practitioners’ Empathy and Health Outcomes: A Prospective Observational Study of Consultations in Areas of High and Low Deprivation
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 117
OP 124
DO 10.1370/afm.1910
VO 14
IS 2
A1 Stewart W. Mercer
A1 Maria Higgins
A1 Annemieke M. Bikker
A1 Bridie Fitzpatrick
A1 Alex McConnachie
A1 Suzanne M. Lloyd
A1 Paul Little
A1 Graham C.M. Watt
YR 2016
UL http://www.annfammed.org/content/14/2/117.abstract
AB PURPOSE We set out to compare patients’ expectations, consultation characteristics, and outcomes in areas of high and low socioeconomic deprivation, and to examine whether the same factors predict better outcomes in both settings.METHODS Six hundred fifty-nine patients attending 47 general practitioners in high- and low-deprivation areas of Scotland participated. We assessed patients’ expectations of involvement in decision making immediately before the consultation and patients’ perceptions of their general practitioners’ empathy immediately after. Consultations were video recorded and analyzed for verbal and non-verbal physician behaviors. Symptom severity and related well-being were measured at baseline and 1 month post-consultation. Consultation factors predicting better outcomes at 1 month were identified using backward selection methods.RESULTS Patients in deprived areas had less desire for shared decision-making (P <.001). They had more problems to discuss (P = .01) within the same consultation time. Patients in deprived areas perceived their general practitioners (GPs) as less empathic (P = .02), and the physicians displayed verbal and nonverbal behaviors that were less patient centered. Outcomes were worse at 1 month in deprived than in affluent groups (70% response rate; P <.001). Perceived physician empathy predicted better outcomes in both groups.CONCLUSIONS Patients’ expectations, GPs’ behaviors within the consultation, and health outcomes differ substantially between high- and low-deprivation areas. In both settings, patients’ perceptions of the physicians’ empathy predict health outcomes. These findings are discussed in the context of inequalities and the “inverse care law.”