Is the general practitioner’s sensitivity to their patients’ psychological problems related to their workload?

Background: Many mental problems are not recognized by the general practitioner (GP). Recognition of these problems is important because it is one of the critical stages in finding appropriate care for the patient. GPs are sometimes reluctant to get involved in mental health care because it requires extra time. We, therefore, investigated if GPs with a higher workload stimulate their patients less strongly to disclose their psychological problems, resulting in less sensitivity to psychological problems. Methods: Data from 2095 videotaped consultations of a representative selection of 142 Dutch GPs were used. Multilevel regression analyses were performed with GP’s psychological sensitivity as outcome measure and workload and communication as predictors. Psychological sensitivity was indicated by GP’s evaluation of the psychological character of the patient’s symptoms. Workload was indicated by list size and GP’s subjective feeling of shortage of time. Communication was rated by observers according to the Roter Interaction Analysis System. Results: Results showed that GP’s sensitivity to psychological problems and GP’s communication are not related to their workload. GP’s psychological sensitivity is clearly related to their communication: showing eye contact, asking questions about psychological topics (P < 0.01), and GP’s empathy (P < 0.05) correspond to more psychological sensitivity. Showing more patient centredness does not increase GP’s psychological sensitivity. Conclusions: Long patient lists or busy moments do not affect a GP’s communication style nor a GP’s sensitivity to patient’s psychological distress. GP’s specific communication skills that stimulate the patient to disclose mental problems are on the other hand important to become aware of patient’s psychological problems. (aut. ref.)