Half of patients perceive barriers when talking to a doctor

Half of all patients perceive barriers when talking to a doctor. More than a third of them – mainly vulnerable patients – welcome support to overcome these barriers. According to researchers from the Netherlands Institute for Health Services Research (NIVEL) and the Academic Medical Center (AMC), simple interventions could already be helpful. The researchers have published their findings in the scientific journal Health Expectations.

Although patients are usually satisfied about the talks they have with their doctor or nurse, many of them could still benefit from support with talking to their health professional. Most patients don’t want to be a nuisance, and many feel time pressure, or they only remember their questions after the consultation has ended. The Netherlands Institute for Health Services Research (NIVEL) research coordinator Professor Sandra van Dulmen: “There's always this big distance, or the tendency to hold back with the doctor. Patients are afraid the doctor is too busy – they see that the waiting room is full and put the doctor’s schedule ahead of their own needs.”
Checking in with the patient
“Doctors have to realise that this is an issue for patients,” she explains. “They have to make more of an effort to find out if patients were able to voice all their questions, and indicate that there’s time to do this during a consultation. On the other hand, patients can prepare a doctor visit and think about questions and concerns beforehand. Doctors could point them towards reliable, high-quality information online or in print, information that patients can look at ahead of time to prepare themselves for the consultation. Right now, a patient often does not understand a medical term without being given the chance to say this. This still happens too often.”
Fewer barriers with nurses
“It’s interesting to note that patients perceive fewer barriers with nurses than with general practitioners and medical specialists,” says Van Dulmen. “Earlier research has shown that patients experience nurses as more approachable. With nurses, they might have less of an impression that there’s ‘too little time.’ Also, nurses are more likely to be women, which might mean that the way they communicate is naturally more patient-centred.”
Gender differences
There are also differences between male and female patients. During a consultation with a doctor, women seem more likely to be hindered by emotions such as fear or shame than men. Van Dulmen: “It can be vey effective to keep this in mind when you help patients get ready for a consultation. Previous research has, for example, shown that helping patients with diabetes to better understand information from their doctor improved the control of their blood glucose levels.”
The study was carried out among 1,314 people with chronic illnesses on NIVEL’s National Panel of the Chronically Ill and Disabled (NPCG). This panel is made up of more than 3,500 people of 15 years of age and older who live independently and have a medically diagnosed chronic illness and/or moderate to severe sensory or motor impairments. 

Cooperating partner
AMC, contact Inge Henselmans