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Body language important for clinical decisions

Non-verbal clues play a key role in GP consultations, influencing both clinical decision-making and patients' evaluation of the doctor-patient relationship, according to a new study.

Researchers at the University of Michigan examined 72 video elicitation interviews and identified a range of non-verbal behaviours which served as tacit clues, including body language, eye contact, physical appearance and tone of voice.

The findings come amid concern in the UK that GPs are increasingly consulting with patients remotely, via telephone or even email. In August, many GPs responded angrily to calls from NHS medical director Sir Bruce Keogh for online consultations to allow GPs to offer'24/7 access'.

Writing in the Journal of Evaluation in Clinical Practice, Dr Stephen Henry, a research fellow at the Department of Internal Medicine at the University of Michigan, said: ‘Our findings show that both doctors and patients identified tacit clues involving the behaviour or appearance of the other, but they were not always able to articulate precisely how these clues informed their judgments and assessments.'

Dr Clare Gerada, RCGP chair, said although face-to-face consultations over a reasonable period of time were the ‘gold standard' there was a place for telephone or even email consultations.

‘What really matters to me is having a good history of the patient and hearing their story and that is 80-90% of the diagnosis,' she said.

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