Expanding Competency of Primary Health Care: Emotional and Bio-Social Meanings for General Practice Consultation

Dear Colleagues,

Within research methodologies, it is always challenging to answer questions and dilemmas that we consider ‘easy’ or expected during our discussions or consultations as general practitioners. The primary care environment is a gate of “events” flow, acting as the interface between real-life data and bio-clinical information. There is a risk that one component may prevail over the other, affecting management output. Able doctors in primary care are those who can link emotional, social and bio-clinical descriptors and offer personalized actions or advice.

In our personal lives, general practitioners ‘borrow’ decision-making techniques from our field. To feed our hypothetical approach, we gained some authentic spot-check descriptions from primary-care attenders within consultations in order to fit the needs of this short introduction. Attenders (A) were asked about their major expectations from their GP. We present their responses to cast more light on this topic:

A-1: “I seek bonding with my General Practitioner (GP). […] Whatever comes up I want to discuss it first with (her/him), ask about (her/his) opinion and then let (her/him) to refer me to another professional.”

A-2: “I want to feel that my GP cares for me, […] to be able to share things that make me feel sad and to trust (her/him).”

A-3: “I want my GP to show understanding and be compassionate, […] to be a good listener and approachable. I don’t want (her/him) to be just a ‘typical’ doctor.”  

Notably, attenders mentioned communicational, emotional and social components. Bonding, caring, understanding, trust and compassion were some of the key elements among the transcripts. People seek consultation from their “family” doctors for several reasons. They expect good clinical ability, but this is beyond the “typical” duty of a doctor. Not being sick does not equate to being healthy. General practitioners have the opportunity to understand what kind of emotional, social and biological aspects influence people’s lives, affecting their health and wellness. This area of research requires expansion, as we believe that only evidence can place this pearl on the ‘crown’ of general practice. We aim to support this effort to transform individuals’ perceptions during consultation into evidence for expanding competency in order to offer better outcomes, adherence to common decisions, and to avoid palindromic diagnoses, care dispersion and patients’ isolation.

We seek original articles concerning positive or negative associations between descriptors such as empathy, connectedness, trust, social bonding, emotional wellness, daily life discomfort or other psychosocial factors and bio-clinical variables from primary-care environments. Articles on the interface of primary and secondary care from a general practice angle are a priority. Reviews approaching psychosocial issues with laboratory research linkages will be well received. Linking morbidity issues with emotional and social descriptors is of interest if the methodology and outcomes lead to robust conclusions. Articles which describe roots of general practice consultation and reasons to change, or explain better outcomes, are also welcome. 

Kind regards,
Prof. Dr. Emmanouil Symvoulakis
Guest Editor

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