The Missing Evaluation at the End of GP’s Consultation

Evaluation at the end of a consultation is an element of a successful encounter. The doctor should inquire if patient’s expectations were fulfilled and sum up the information given, the examinations performed, and the decisions made with the patient. This way the patient would be fully aware of what has been decided and that the problems and expectations of the patient had been taken into account. Twenty consultations of four general practitioners (GPs) in Finland were videotaped. The doctors were men and women, two of them had a long experience and two were trainees in general practice. The data (videotapes, questionnaires, and interviews) were analysed by multiple research methods with investigator and methodological triangulation. MAAS-Global Rating List was used as an assessment tool. The evaluation of the consultation was often missing or having shortages; only one-third was assessed to be better than doubtful. The assessments done by experienced GPs and the medical student were similar. According to the result of this study as well as the information in the current literature, doctors in all periods of their career should repeatedly be reminded about the importance of the evaluation at the end of the consultation. 1. Introduction Patient centred approach, good patient-doctor relationship, and good communication skills are related to patient satisfaction, better outcome, and lower health care costs [1–3]. On the other hand, problems of patient-doctor communication are often the reason for complaints to medical regulatory authorities [4]. Poor information and lack of support by the health care personnel are related to a lack of adherence to treatment [5]. Some of the GP’s core competencies are person/patient centred care, holistic modelling and comprehensive approach [6, 7]. There has been a discussion of the definition of patient centred care and, for example, patients’ participation in the shared decision making [7–9]. The patients find it important to share their own view during the consultation, but, on the other hand, they expect their doctor to be an expert and an authority [10]. The patients do not always want to be involved in decision making, depending on the problem, age, or social class [11]. Doctors need skills to change their consultation style consistent with their patients’ expectations and needs [8, 11]. According to some studies, longer consultations have been related to better communication and patient satisfaction [1, 7, 12]. And yet, the consultation length varies in different countries and is influenced by doctor and the country