Does questionnaire-based patient feedback reflect the important qualities of clinical consultations? Context, benefits and risks.

OBJECTIVE To explore perceptions of clinical consultations and how they relate to questionnaire-based patient feedback. METHODS Telephone interviews with 35 junior doctors and 40 general practice patients who had used the Doctors' Interpersonal Skills Questionnaire (DISQ). RESULTS Doctors and patients had similar views of 'good consultations' as relying on doctors' listening and explaining skills. Preferences for a consultation style focused on an outcome or on the doctor-patient relationship may be independent of informational and/or affective consultation content. Respondents felt the important consultation elements were similar in different contexts, and so DISQ feedback would be useful in different settings. Benefits of feedback were identified in the form of patient empowerment and doctors' learning. Risks were identified in the inappropriate use of feedback, both inadvertent and deliberate. CONCLUSION The style and content of consultations may be considered as separate dimensions, an approach that may help doctors adapt their communication appropriately to different consultations. Patient feedback focused on communication skills is appropriate, but there are potential risks. PRACTICE IMPLICATIONS Doctors should consider the transactional or relational preference of a patient in approaching a consultation. Patient feedback can deliver benefits to doctors and patients, but risks must be acknowledged and mitigated against.