What matters for patients when choosing a doctor?

When selecting a primary care provider (PCP), patients in Singapore look beyond the medical expertise and seek a physician who is empathetic and has strong interpersonal abilities.

In an interview-based study conducted by researchers from SingHealth Polyclinics, factors such as the doctors’ personality, ability to communicate effectively, professionalism, and, in some cases, shared demographics influenced the patients’ choice of a PCP. [PLoS One 2024;19:e0298823]

Ideal PCPs were described to be overall pleasant and caring, empathetic, compassionate, sincere, and dedicated. One respondent expressed wanting a doctor who did not seem rushed and took time to listen to his or her patient’s concerns. Another respondent believed that a doctor who demonstrated genuineness and concern could inspire confidence in patients and get them to open up not about anything personal but more so about medicine and health-related issues.

Additionally, PCPs’ verbal, nonverbal, and listening skills were valued, with a strong rapport with patients being seen as key for ensuring that a patient receive continuous care from the same physician. The respondents said that they appreciated when doctors made eye contact with them and could clearly explain things or provide advice that was easily understood.

A close and harmonious relationship with PCPs, according to one respondent, helped patients feel comfortable during consultations. Meanwhile, another respondent recalled an unpleasant experience with a doctor, where the said doctor conducted the consultation without lifting his or her eyes from the computer monitor to look at the patient.

In terms of PCPs’ professionalism, the respondents valued competency and a patient-centred approach to care. The respondents wanted PCPs who could not only help patients with their medical conditions but also provided holistic care. This meant that doctors who were detailed and thorough and willingly asked about any other problems that the patients might have were preferable. Additionally, as the respondents sought to play an active role in the management of their disease, PCPs who would explain the pros and cons of a treatment or intervention were seen as ideal.

Finally, some respondents considered the doctors’ age and gender that they felt comfortable with when choosing PCPs.

The importance of trust

“The factors revealed in this study have been consistent with existing literature. The emphasis is on the partnership between the physician and patient. Patients valued a relationship with their PCPs underpinned by trust, which is also predictive of their satisfaction with their provider,” the researchers noted. [Mayo Clin Proc 2006;81:338-344; BMC Fam Pract 2020;21:107; BMC Med Inform Decis Mak 2015:15:63; BMC Fam Pract 2013;14:8; BMC Fam Pract 2020;21:196]

Seeing the same doctor repeatedly has been shown to effectively build trust among patients, leading to better communication and, ultimately, improved health outcomes. The researchers suggested that healthcare systems prioritize fostering these long-term relationships between patients and their providers. [Ann Fam Med 2010;8:440-446; J Eval Clin Pract 2010;16:947-956]

Overall, the present data sum up the key physician factors for PCPs to adopt in order to sustain their clinical practice when the healthcare system reverts to a capitation-based healthcare financing model, the researchers said. “It is important for PCPs to have insight into patient preferences, so that their practices and patient interactions can be evolved to enhance the physician-patient relationship.

“One possible way would be to upskill PCPs in refresher communication and professionalism training programmes… Reporting carefully selected clinical quality indicators among anonymized clinical practices may nudge the PCPs through ‘upward social comparison’. Pitching themselves to their peers can potentially motivate the PCPs to evolve to a more patient-centred clinical practice,” they added.