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GPs in deprived areas 'appear less empathetic'

GPs in deprived areas appear less empathetic towards patients due to time constraints and increased multimorbidity in these areas, a new study has found.

The study, published in the Annals of Family Medicine, examined the consultations of 659 patients in 20 practices, and found that GPs’ verbal and non-verbal communication was less ‘patient centred’ in deprived practices, compared to richer ones, and GPs spent more time looking at computer screens during consultations with patients from poorer areas.

Professor Stewart Mercer from the University of Glasgow, lead author of the study said: ‘It is not to suggest GPs working in deprived areas are un-empathetic, but rather that they face a higher workload and have patients with complex needs.’

Professor Mercer added: ‘Because of the inverse care law, the GPs in those deprived areas struggle to deliver patient-centred care due to time and resource constraints, and thus the NHS is not working best where it is needed most.’

This follows research that GPs in the poorest areas get £10 less per patient than average practices.

Dr Miles Mack, chair of RCGP Scotland, said: ‘Right across the country GPs and patients are facing closed or restricted lists, reduction of services, GPs being forced to leave the profession or to work elsewhere, and longer and longer waiting times for appointments. It is unacceptable. This research is further proof that a lack of appropriate investment damages patient safety.’

The research from the University of Glasgow and the University of Southampton was funded by Scottish Government’s Chief Scientist Office.

Readers' comments (17)

  • Was working in a deprived area the first choice of the GPs?. Were they unsuccessful if previouisly had applied to better off areas. it is easier to treat poorer people with less respect or good quality consultations and treatments as they will not have the confidence to deal with it. Are less able doctors working with those who need the best because of snobbery and social class issues?

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  • What about practices struggling with large elderly populations where multi morbidity is compounded by frailty rather than deprivation. Having worked in both affluent and deprived areas I remain far from convinced colleagues in deprived areas are under more pressure.

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  • I miss the easy gig of multiple no shows in a surgery since moving to the burbs.
    They trot out the same only academics with these things.
    We are all under pressure!

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  • In response to 6:45...As someone who works in a very deprived area, has off scale multi morbidity, well above average profile of elderly and a very rural area. I would state multi-morbidity, followed by derivation and rurality are the biggest factors in workload. When I did a top 10 recently of factors high elderly population only just came in the top 10.
    The burden on young illness which comes with a deprived population if managed properly can not be underestimated.

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  • So, how do you measure empathy?

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  • I love a bit of academic nonsense!
    If these guys would put in a days graft as proper GPs rather than indulging in yet more navel gazing it may help us all with our workload crisis.
    So many potential confounders here - where do you start.
    The CARE questionnaire you gotta love it - just ask any Scottish GP who has to use this for appraisal. Pure fluff.

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  • Mirroring of patients as empathy as a confounding factor? Could researchers identify a consultation with a middle class educated person as being more empathetic as it is similar to them?

    That said my empathy drains earlier and earlier in the day currently.

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  • Empathy lacking - absolutely not. It's the other way round because a GP without empathy would rather move to a rich area.
    Funding lower than other areas - an absolute yes.
    And not just a £10 shortfall but £46 as in the case of a Practice in Strood, Rochester which is paid £90 per patient including premises reimbursements.
    The problem lies in interpretation of what is a deprived area and what is a rural area. We have a Surgery in a posh locality with more than 10000 patients classified as 'rural' and given above average payments while a deprived Practice is classified as not so deprived and given almost 30-40% less per patient. One so called rural with almost 10k patients is padi £165/patient while another in Walderslade is paid rent reimbursement of £189000 per year.
    Transparency in the system and removal of the formula is what we need. A review of Practices classified as rural will show that some of these have CCG bosses sitting as partners. Correct me if I am wrong.

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  • More holes in the conclusions drawn in this study than a nice piece of Swiss cheese!

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  • DUH!!!
    Why bother carry out this study???
    Rather than just finding another way to bash gps, they should be looking at how the monkeys there are gps left in these deprived areas.

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