Shifts in doctor-patient communication during a series of outpatient consultations in non-insulin-dependent diabetes mellitus

As the treatment of non-insulin-dependent diabetes mellitus (NIDDM) largely depends on self-management, patient compliance and satisfaction, diabetes-specific beliefs and fears need special consideration during medical consultations by means of effective communication. Communication patterns are likely to change through time. For that reason, the first three consultations between 18 newly referred patients with poorly controlled NIDDM and their medical specialist were videotaped. Subsequently, changes in doctor's and patients' verbal and nonverbal communication behaviours during these 54 consultations were analysed. Furthermore, an investigation was carried out to distinguish those communication behaviours most strongly related to patient satisfaction. Findings suggest that the first consultation is most important for building an effective doctor-patient relationship, the second for discussing treatment matters, and the third for addressing psychosocial issues. Further research incorporating clinical outcome measures is recommended to determine which were the behaviours with the greatest influence on patient health outcome.