Context factors in general practitioner - patient encounters and their impact on assessing communication skills - an exploratory study

Table 1 List of context factors

Doctor-related factors		Present in # consultations (%)
1.	Doctor knows patient and his social context	29 (72)
2.	Doctor knows patients’ medical history	35 (88)
3.	Doctor knows patients’ way of communicating	29 (72)
4.	Doctor is very experienced	34 (85)
Patient-related factors
5.	Specific patient verbal behaviour	11 (27)
6.	Specific patient non-verbal behaviour	1 (3)
7.	Patient is also treated by other provider	12 (30)
8.	Patient has a disease (diagnosis) or (recurrent) problem known to both doctor and patient	24 (60)
9.	Patient is familiar with (physical) examination (PE)	23 (58)
Consultation-related factors
10.	Single consultation	23 (58)
11.	First consultation in a series¹	4 (10)
12.	Follow-up consultation in a series²	11 (28)
13.	Consultation in a series based on protocol (initiative by doctor)³	1 (3)
14.	Consultation in preventive care (initiative doctor)⁴	1 (3)
15.	Diagnosed problem is easily solved	3 (8)
16.	Problem urgently needs medical care	1 (3)
17.	Diagnosed problem is mainly psychosocial	2 (5)
18.	There is more than one person (patient) present	12 (30)
19.	Characteristics of physical examination:
	- simple	30 (75)
	- invasive	4 (10)
	- intimate	6 (15)
	- superficial	29 (73)
	- leaves room for talk	10 (25)
	- requires full attention	27 (68)

Context factors present in 40 GP consultations (+ frequency).
¹a first consultation in a series is a consultation in which no diagnosis is being made and patient is referred for further tests, or in which doctor and patient agree to a follow-up consultation for check-up purposes.
²a follow-up consultation in a series is a second or consecutive consultation concerning a complaint or problem for which a referral was made, or that was agreed upon by patient and doctor. It is also marked as a follow-up consultation if the patient has been referred for specialist care (even if surgery took place) and the patient comes back to report on that. (no maximum time span is indicated)
³a protocol based consultation is a consultation, concerning a prior diagnosed complaint or problem, that is initiated by the doctor on the basis of a protocol or clinical practice guideline.
⁴a preventive consultation is a consultation that is initiated by the doctor on the basis of a protocol or clinical practice guideline (diagnosis or disease is not necessarily established).

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