It goes without saying that GPs are passionate about providing the best possible care and have the very best of intentions concerning all their patients.
However, in this ‘information era’, patients are better informed about their health and what modern medicine can achieve. And while engaged patients are valuable for GPs, high expectations can sometimes cause confusion between what patients want and what the GP can actually deliver.
Medical Protection recently commissioned a YouGov online survey of over 2,000 British adults and reassuringly found that 80% of the public believe their GP does meet their needs and expectations.1
But what really matters to patients when they visit their GP?
As part of the YouGov survey, we also asked the public which one of the following options was most important to them:
- The bedside manner of my GP (e.g. how they treat and communicate with you as a person)
- The manner of frontline staff at the surgery (i.e. receptionists)
- Receiving sympathy or understanding from my GP
- The ability of my GP to clearly communicate with me (e.g. in plain English, explain any jargon terms etc.)
- That my GP is open and honest
- The clinical expertise of my GP
- That my GP actively encourages me to be involved in making decisions around my own healthcare
- Having enough time to discuss my care in detail with my GP
- Being able to access GP services outside of normal GP opening hours
- The willingness of my GP to provide the treatment I request
- Accessibility to home visits
- None of the above
- Don’t know
Clinical expertise was the most-selected option for those surveyed, with almost one quarter of the public (23%) selecting this as the single most important factor to them when having an appointment with their GP.
We asked our GP members the same question (i.e. what they thought the single most important factor was to patients when they presented for an appointment). Clinical expertise was the third most-selected option (by 12% of respondents), closely behind bedside manner and having enough time to discuss patient care in detail.2,3
The results are understandable from a patient perspective but it is a little surprising that clinical expertise ranked as only third for GPs. It may be that some GPs take competence as a given, whereas they may be more aware of areas where they feel they lack confidence and training.
This represents a welcome change where healthcare professionals now appreciate the need to build a solid doctor-patient relationship.
Enough time to discuss patient care in detail
Both patients and GPs selected ‘having enough time to discuss the patient’s care in detail’ as the second most-important issue during a consultation, chosen by 16% of the public and 19% of Medical Protection members.
This is unsurprising as time constraints often feature in complaints and are an ongoing frustration for GPs too.
While proposals have been presented by NHS England in the GP Forward View and also by the BMA to address various demands on GP practice, it is unclear how these issues will be resolved as we face a potential workforce crisis. However, it has been agreed that change is needed - and fast.
Openness and honesty
The ability of a GP to be open and honest was the third most selected option for patients, with 15% of the public considering it to be the single most important factor when having an appointment. This was contrasted by only 4% of Medical Protection GP members selecting this option.
When considering these results alongside another Medical Protection member survey from early 2015, which found that over two in three (68%) respondents either agreed or strongly agreed that the culture in healthcare was one of blame and shame (and that it would be difficult to overcome this), it is clear that cultural and behavioural change is still needed to promote openness, professionalism and accountability amongst those working in healthcare.4
Medical Protection strongly believes that the successive governments have put too much focus on penalising healthcare professionals, when they should be trying to create an open learning culture. This could be achieved by prioritising the development of mentoring, education, training and leadership programmes.
Notably, the majority of Medical Protection GP members considered bedside manner (e.g. how they treat and communicate with patients) to be most important to patients when they have an appointment, with almost half (43%) selecting this option.
Although bedside manner was not ranked as highly among the public (it was the fifth most selected option, with 10% of the public rating this as their single most important factor when having an appointment with their GP), we know that poor bedside manner can be a key factor in patients bringing about a complaint or claim. It is therefore positive to see that GPs recognise this too.
We must also consider the limitations of the survey, which includes the views of people who may not be current patients, and people who have only ever visited their GP for a product, such as a repeat prescription or immunisation rather than for something more personal, where bedside manner may be considered to be more important.
It would therefore be interesting to compare results from these groups in a future survey.
- Dr Pallavi Bradshaw is a senior medicolegal adviser at Medical Protection
- All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 2021 British adults. Fieldwork was undertaken between 26 – 31 May 2016. The survey was carried out online. The figures have been weighted and are representative of all GB adults (aged 18+).
- Medical Protection conducted a survey of 707 GP members in May 2016 to determine their views on patient expectations.
- The same question was used in both the YouGov and Medical Protection surveys, however, Medical Protection members were not provided with ‘None of these’ or ‘Don’t know’ options.
- MPS conducted a survey of 536 UK GPs, consultants and non-consultant hospital doctors in April 2015 titled ‘Openness, Risk and Regulation’.