Exploring the relationships between participatory decision-making, visit duration, and general practitioners' provision of argumentation to support their medical advice: results from a content analysis.

Abstract

OBJECTIVE: General practitioners' medical recommendations are not always accepted by their patients. As patients bring their own beliefs, knowledge, and preferences to the medical encounter, their opinions concerning diagnosis and treatment may deviate from their doctors'. Aiming to convince their patients of the acceptability of their advice, doctors can advance arguments. Few quantitative studies have been conducted focusing on general practitioners' provision of argumentation and little is known about the relationship between the use of argumentation and characteristics of the medical visit, such as (participatory) decision-making and visit duration. This study seeks to explore these relationships. METHODS: An observational study of seventy, randomly drawn videos of general practice consultations was conducted. A theory-based codebook was developed. Two independent coders analyzed doctors' provision of argumentation, their decision-making style, and the duration of each visit. RESULTS: General practitioners' provision of argumentation was found to be associated with lengthier visits and a more participatory decision-making style. In addition, visit duration and participatory decision-making appeared associated. CONCLUSION: These results suggest that the use of argumentation may contribute toward achieving patient-centered care through communication. PRACTICE IMPLICATIONS: As a result, the findings underscore the potential relevance of developing courses focusing on doctors' argumentation skills.