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GPs go forth

GPs urged to touch patients during consultations

GPs have been encouraged to touch patients ‘expressively’ in consultations to help make patients more relaxed, say researchers.

The study

The qualitative analysis included 15 GPs and 11 patients was carried in practices in Greater Manchester and north Derbyshire. Each doctor was interviewed and asked to contact one or two patients with a long-term condition, with whom they considered they had an ongoing relationship. Semi-structured interviews with patients analysed their opinions regarding improving communication with GPs.

The findings

Patients said non-verbal empathic listening was particularly important for good communication, and using touch was also suggested to improve communication quality for all patients and most GPs. GPs reported that touch signified politeness, warmth and helped make a clinical encounter more relaxed.  Touching as part of a clinical task was noted as being reassuring by GPs, and often both procedural and expressive. However, some GPs felt the use of anything other than procedural touch had situational limits, while the majority of patient responders believed touch would be well received. Both patients and GPs felt that touch on the hand and forearm was acceptable, but not elsewhere.

What does it mean for GPs?

The authors felt that ‘raising doctors’ awareness about the potential for consciously using expressive touch in consultations will provide GPs with another tool to improve doctor-patients communication.’ They added that the data ‘suggest that increased educational emphasis on the conscious use of expressive touch would enhance clinical communication.’

BGJP 2013, online 25 February

Readers' comments (11)

  • Thse academic types should be lined up and shot

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  • Ok. 15 GPs and 11 patients. Qualitative analysis.

    Where should one start? Insufficient powering, selection bias or complete lack of meaningful end points.

    This, at best, shows that there might be grounds to do a meaningful study to determine if this is generally true. As it stands it is for a small group of GPs who wanted to do it for an even smaller group of patients.

    To class this as "academic" is truly flattering.

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  • Why does the website think the "GMC relaxes guidance on sex with ex-patients" is a 'related article'?

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  • Some years ago a series of articles was started in the Journal of the American Medical Association entitled "The Rational Clinical Examination" (it;s probably still going). It commenced by lamenting a trend in patient encounters, involving the competion of an extensive form by the patient in the waiting room (insted of proper history-taking by the physician) and the ordering of various tests (instead of actually examining the patient), and of course diagnoses being founded on the results of these.

    The general consensus amongst correspondents at the time was that physicians were in danger of losing touch with their patients, and that the 'hands-on' approach was what was most appreciated by patients.

    Perish the thought that pretty soon we shall have patients going through a diagnostic 'scan' as they walk through the door to the consultation room.

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  • As a practicing Community Dental Surgeon it is difficult not to be in close approximation to the patient and as many of the nervous/phobic younger patients need to be encouraged to appreciate that contact does not imply imminent pain and is in fact reassuring. If you do not want the profession to be taken over by robots then keeping the personal touch is essential.

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  • I must admit the numbers involved in this study does leave something to be desired in terms of a "validated" trial

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  • Ugh. The touchy-feely approach is not for everyone. I'm British, and proud of it. Please don't pat me on the arm!

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  • What about stroking and squeezing?
    Maybe the GMC could limit it: 5 strokes (only 1 if the patient is British) and 3 squeezes (5 if British).

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  • yuk..hands off!

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  • This isn't a trial - it is a qualitative study. When conducting qualitative research there are no sample sizes/power calculations. Instead you aim for saturation in your sample. Qualitative research is often very useful in identifying areas that require quantitative research e.g. in identifying relevant research questions. It seems that some of the commenters should probably brush up on their research methodology; How to Read a Paper by Trish Greenhalgh is very good and very readable.

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