• Roger Ruiz-Moral, Esperanza Pérez Rodríguez, Luis Angel Pérula de Torres, and Javier de la Torre.
• Family Medicine Teaching Unit, Cordoba School of Medicine, COGRAMA Group, Spanish Primary Care Research Network (redIAPP), Spain. roger.ruiz.sspa@juntadeandalucia.es
• Patient Educ Couns. 2006 Dec 1;64(1-3):242-8.

ObjectiveTo explore the communicative behaviours as used by specialty physicians, and their patients' perception of the communicative act as well as their satisfaction with the encounter.MethodsCross-sectional study involving 27 specialty physicians and 257 outpatients. Encounters were video-recorded and analysed through the GATHA-ESP scale. Patients rated the quality of the interaction and their satisfaction with it in a questionnaire.ResultsMost specialist doctors use a "managerial" style where there is no exploration of their patients' emotions (22%), expectations (28%) or psychosocial aspects (10-20%). Less than one doctor out of every four ever gave the patient an opportunity to participate in any type of decision making at the surgery. Patients were more satisfied with those encounters they felt more patient-centred (F: 11.37; p<0.001); higher scores on the GATHA-ESP characterised these visits.ConclusionsSpecialty physicians show a limited range of communicative skills as they use a doctor-centred style that allows for little patient participation. Patients' perceptions of patient-centeredness are linked to satisfaction more than the analysis of doctors' behaviour at the consultation does.Practice ImplicationsIt seems important to foster training in communication skills in the different specialist vocational training programs. Studies on physician-patient communication should deal with the perceived and observed perspectives on this domain.

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