Barriers to improve physician–patient communication in a primary care setting: perspectives of Chinese physicians

ABSTRACT This study aims to evaluate Chinese physicians’ performance of communicating with patients in a primary care setting, and to discuss barriers to improving physician–patient communication from physicians’ perspectives. Physicians’ performance in communicating with patients during primary care consultations were evaluated using a self-developed communication assessment checklist. Field observations of 7 primary care providers were conducted and their performance in 182 consultations was observed and assessed. In-depth interviews were carried out with each physician after the observations. The results of observations indicated that Chinese physicians generally performed poorly in interacting with patients and their communication style relied mainly on their personality and experience. The results of interviews revealed four barriers to improving physician–patient communication, which were the low medical literacy of patients, the high workload for physicians, the low awareness of communication skills and the adoption of defensive behaviors among physicians.