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Communication style in primary health care in Europe

Atie van den Brink‐Muinen (Netherland Institute for Health Services Research (NIVEL), Utrecht, The Netherlands)
Heidi‐Ingrid Maaroos (Department of Family Medicine, University of Tartu, Tartu, Estonia)
Heli Tähepõld (Department of Family Medicine, University of Tartu, Tartu, Estonia)

Health Education

ISSN: 0965-4283

Article publication date: 29 August 2008



This paper aims to investigate doctor‐patient communication in consultations of newly qualified general practitioners (GPs) in a newly reorganised health care system and differences in consultation characteristics and communication patterns between new European Union (EU)‐countries (Estonia, Poland and Romania) and the old West‐European EU‐countries.


Observation of videotaped doctor‐patient consultations by means of Roter's Interactional Analysis System; GP, patient and observer questionnaires. Data were collected from 92 GPs and 1,376 patients in Estonia, Poland and Romania and compared with known data from old EU countries. Main outcome measures were verbal and nonverbal communication of GPs and patients, as well as consultation characteristics.


Differences were found in the communication patterns of the new EU‐countries Estonia, Poland and Romania compared to the old EU‐countries. For instance, the verbal contribution of the GPs in the new EU‐countries was greater than in the old EU‐countries. Differences were also found between the three new EU‐countries. In Romania there was more psychosocial talk than in the two other new EU‐countries, whereas in Poland and Estonia there was more biomedical talk. The Estonian communication was more affective, the Polish and Romanian more instrumental. In general, the differences were not found to be related to a “new‐old” or “east‐west” distinction. Clearly, cultural norms and values play an important role in doctor‐patient communication.

Research limitations/implications

The sampling method differed somewhat from one country to another.

Practical implications

With the integration of Europe in progress, cross‐cultural aspects should be addressed when doctors are being trained in communication skills in their undergraduate and postgraduate education.


This is the first study to investigate doctor‐patient communication in newly reorganised health care systems and differences in doctor‐patient communication between new and old EU‐countries.



van den Brink‐Muinen, A., Maaroos, H. and Tähepõld, H. (2008), "Communication style in primary health care in Europe", Health Education, Vol. 108 No. 5, pp. 384-396.



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