Why we need to listen to patients and general practitioners
Findings from a 2020 research project by Healthy Primary Care
By Bryce Brickley, PhD Candidate
General practitioners (GPs) play an essential role in health care. They focus on the acute treatment of a variety of illnesses (e.g. infections), the management of chronic disease (e.g. diabetes) and preventative health care (e.g. cancer screening) (1). In Australia and many countries throughout the world, GPs are expected to provide care that is individualised and centred on the patient (2, 3). The concept of patient-centred care describes care that is respectful and responsive to the needs and wishes of patients (4). High levels of patient-centred care have been associated with deep relationships between clinicians and patients (5), greater adherence to treatment (6) and patient satisfaction (7).
Previous research has shown that health consumers have varied experiences when engaging with GPs (8, 9). Indeed, most are positive, and GPs deliver care that is centred on patients. Although, this is not always the case, and people can have negative, harmful experiences in general practice (10). Researchers are now exploring new ideas to promote patient-centred care and support both care providers and health consumers. Supporting general practice and their patients is a priority for the Gold Coast Primary Health Network, and this study could not have been completed without their support.
In this article, I will explain new research findings regarding the perceptions and experiences by GPs and patient advocates of patient-centred care. The new findings arose from a recent research project by Healthy Primary Care, which was led by Mr Bryce Brickley (PhD Candidate) and published in BMJ Quality and Safety (impact factor: 6.087, h-index: 126). Click here to access the full article.
What did this research project involve and who were the participants?
The study was a qualitative study involving focus group interviews. Round-table discussions were held with a total of 15 patient advocates and 12 practising GPs based in south-east Queensland and northern New South Wales. Patient advocates and GPs addressed structured questions on their experiences and views of patient-centred care. Patient advocates are individuals who are trained in participating in research and are typically paid for their time and expertise through advocacy organisations. In their engagement activities, patient advocates put the needs, preferences and wishes of patients in their local community first. Patient advocates also commonly speak as an ‘expert patient voice’ in research, but there is little known about patient advocate’s views and experiences of patient-centred care. Interview data was analysed by the Healthy Primary Care team, which was then developed into core themes.
What are the main findings?
Patient advocates and GPs had varied views and experiences regarding patient-centred care. The five main learnings from the study are presented in the following infographic:
Who do the findings impact, and how can the findings be used?
The main findings of this study have implications for patients, GPs, researchers and general practice staff. Engaging with GPs and patients provided valuable insight into their perspectives and experiences. In the future, both patient advocates and GPs should continue to be engaged to provide feedback to researchers, primary care organisations and policy-makers. In practice, both patients and GPs need to be supported with new strategies to re-hone general practice staff and patients’ knowledge of, and skills in, patient-centred care. A collaborative initiative focusing on the continued education of patient-centred care by GPs and patients can raise awareness and promote a uniform understanding of patient-centred care in the practice.
This work can be used to inform the development of strategies to promote and facilitate higher levels of patient-centred care provided by GPs.
Now I’d like to hear from you. Do your views of patient-centred care align with your GP’s views? How can you partner with your GP and general practice to promote patient-centred care?
Contact me on twitter: @HPC_Griffith and @BryceBrickley
Contact me on email: @email@example.com
1. Royal Australian College of General Practitioners (RACGP). What is General Practice? 2019 [8 June 2020]. Available from: https://www.racgp.org.au/education/students/a-career-in-general-practice/what-is-general-practice.
2. The Royal Australian College of General Practitioners (RACGP). Vision for General Practice and a Sustainable Healthcare System: White Paper, February 2019. East Melbourne, Victoria; 2019.
3. Stewart M, Brown J, Weston W, McWhinney I, McWilliam C, Freeman T. Patient-centred medicine: transforming the clinical method. Abingdon, United Kingdom: Radcliffe Medical Press; 2003.
4. World Health Organization. People-centred and integrated health services: an overview of the evidence: interim report. World Health Organization; 2015.
5. Kinmonth AL, Woodcock A, Griffin S, Spiegal N, Campbell MJ. Randomised controlled trial of patient centred care of diabetes in general practice: impact on current wellbeing and future disease risk. BMJ. 1998;317(7167):1202-8.
6. Saha S, Beach MC. The impact of patient-centered communication on patients’ decision making and evaluations of physicians: a randomized study using video vignettes. Patient education and counseling. 2011;84(3):386-92.
7. Bauman AE, Fardy HJ, Harris PG. Getting it right: why bother with patient-centred care? The Medical Journal of Australia. 2003;179(5):253-6.
8. Cocksedge S, Greenfield R, Nugent GK, Chew-Graham C. Holding relationships in primary care: A qualitative exploration of doctors’ and patients’ perceptions. British Journal of General Practice. 2011;61(589):e484-e91.
9. Abdulhadi N, Al Shafaee M, Freudenthal S, Ostenson C-G, Wahlström R. Patient-provider interaction from the perspectives of type 2 diabetes patients in Muscat, Oman: a qualitative study. BMC Health Services Research. 2007;7:162-. 10. Garrison GM, Bernard ME, Rasmussen NH. 21st-century health care: the effect of computer use by physicians on patient satisfaction at a family medicine clinic. Family Medicine-Kansas City-. 2002;34(5):362-8.