Identification of high-quality consultation practice in primary care: the effects of computer use on doctor–patient rapport

If the practitioner uses a clinical computer during consultation with the patient there may be adverse effects on the quality of interpersonal communication in the consultation. Greatbach et al showed in 1995 that these adverse effects might be minimised when the practitioner is well-practised and able to put in the background the tasks involving the computer.1 In the subsequent seven years, as clinical computer systems have become more sophisticated, the clinician may be called on to pay more attention to the content displayed on the computer screen. This study shows that this required level of attention cannot be put in the background, and that general practitioners (GPs) are not able to multitask at this level. Clinicians can use specific communication skills to manage the consultation, so that they are not called on to concentrate on the computer screen and the patient at the same time. The two tasks can be accomplished in the same consultation, but not simultaneously