Introduction

Communication skills play a pivotal role in healthcare systems and are recognised as a fundamental aspect of professionalism, significantly influencing the quality of care provided by general practitioners [1]. Effective communication and interpersonal skills are the cornerstone of successful medical practice and can have a profound impact on patient satisfaction, adherence to medical recommendations and health outcomes [2]. The doctor-patient relationship has evolved over time, transitioning from a paternalistic model to a patient-centred approach that respects patients’ needs, autonomy and preferences. Today, patient-centred care is becoming increasingly prominent in clinical practice, encouraging general practitioners to consider illness from the patient’s perspective [2]. Key communication skills include listening, providing clear and comprehensible health guidance and adapting communication style and responses to align with the patient’s needs, perceptions and emotions [3]. Given these developments, general practitioners and healthcare professionals are expected to proactively address patients’ expectations by employing effective communication strategies to explain diagnoses, conduct thorough examinations and formulate treatment plans. Moreover, general practitioners are required to demonstrate competencies such as delivering bad news sensitively, providing effective health counselling, communicating efficiently with patients’ families, dedicating sufficient time for consultations, maintaining professional and courteous manners and respecting patients’ emotions [4, 5]. The effectiveness of communication is shaped by multiple factors, including economic and cultural influences [6]. The quality of doctor-patient communication also depends on the nature of their relationship, which is, in turn, influenced by the personality traits of both parties. Ideally, general practitioners should consider their own personality traits when adapting their communication approach with patients. Within healthcare, communication is not only a clinical skill but also a therapeutic tool that fosters meaningful relationships and benefits all involved [7]. Research suggests that the communication skills of general practitioners do not always align with patient expectations [8]. Scientific literature indicates that doctors may underestimate the importance of effective communication [9]. Many general practitioners believe they possess adequate health communication skills and often overestimate their ability to communicate effectively with patients [10–12]. Additionally, general practitioners may be unaware of how patients perceive their communication practices. As a result, there might be discrepancies between how doctors and patients assess the quality of communication during consultations [13]. General practitioners emphasise the importance of medical knowledge and experience, as well as the role of competence and efficiency. They assess relationships based on their problem-solving abilities, usefulness, reliability and credibility. However, they often overlook the ‘softer’ aspects of interpersonal interactions, such as care and empathy, which are particularly important to patients. This misalignment of expectations can contribute to a loss of trust in the doctor-patient relationship [14]. A study conducted among general practitioners in Germany, Greece, Spain and Cyprus identified significant gaps in knowledge, skills and training related to health communication [15]. The analysis highlights multiple areas requiring improvement in doctor-patient communication, with verbal communication – particularly questioning and listening skills – identified as a key challenge [16]. Studies indicate that strong verbal communication skills, such as active listening, greeting patients and expressing gratitude for their cooperation, are essential to fostering effective communication with patients. Furthermore, an empathetic and compassionate attitude directly enhances patient satisfaction with medical consultations. Providing comprehensive information about a patient’s condition and treatment is crucial in ensuring they fully understand their diagnosis or therapy. These elements contribute to building trust and strengthening the doctor-patient relationship [17, 18]. Research conducted in the United States suggests that many patients withhold or misrepresent important health information when speaking with their doctors. In fact, 60–80% of Americans admitted to not being truthful about details that could be relevant to their health [19]. This highlights the critical role of effective communication and trust in maintaining or restoring health. In light of these considerations, this study aimed to identify both strengths and areas requiring improvement in interpersonal skills among Polish general practitioners, as well as to examine the factors influencing their communication skills.

Material and methods

Results

The majority of respondents were women (60.3%), and one in three respondents (30.4%) was aged between 41 and 50 years (Table I). Most respondents had between 11 and 30 years of professional experience. The respondents most commonly worked in cities with fewer than 200,000 (41.8%) inhabitants. The vast majority (92.5%) considered in-person consultations to be the most effective and preferred form of patient consultation. For more than half of the respondents (53.0%), the average consultation time per patient ranged between 10 and 15 min. Two-thirds (66.3%) believed this consultation time was sufficient. More than half (56.3%) of the respondents reported seeing an average of over 30 patients per day (Supplementary Table SI). The vast majority (98.5%) of respondents believe that a doctor’s communication skills are important for patients. Most primary care doctors (94.5%, combining responses rated as ‘very good’ and ‘good’) assessed their communication skills positively. The survey revealed that just over 60% of doctors had not participated in training, conferences or workshops aimed at enhancing doctor-patient communication. The overwhelming majority (97.2%) of respondents agreed that practical communication training specifically designed for doctors is necessary. The maximum possible score on the Interpersonal Communication Skills Inventory was 120. The average score achieved by respondents was 72 points. Women scored significantly higher than men: 73.1 vs. 70.3 points (Table I). Doctors who rated their communication skills as poor or very poor scored higher (82.5 points) than those who rated them as good or very good (72.3 points). A significant difference in scores was also observed in relation to the assessment of the adequacy of consultation time. Doctors who considered the consultation time to be sufficient scored lower than those who perceived it as insufficient (70.6 vs. 74.8 points).

An analysis of the individual areas of communication skills revealed that the strongest area of communication skills among doctors was, in particular, Sending Clear Messages (Table II, Figure 1). For the remaining communication skills, particularly in Listening and Giving and Receiving Feedback, respondents scored lower.

Figure 1

Communication skills of general practitioners: average scores for the assessed areas (source: own calculations)

Discussion

This study found that the strongest communication skill among the respondents was Sending Clear Messages. Similar findings were reported in a Lithuanian study on healthcare professionals [20]. Interestingly there is evidence that doctors who expressed uncertainty about diagnoses and lacked the competence to provide thorough explanations experienced lower levels of patient trust and a reduced adherence to treatment effectiveness among patients [21].

In another Polish study, it was found that the most highly rated aspects of communication included allowing the patient to speak without interrupting (50.4%), speaking in a way that the patient could understand (47.6%) and paying attention to the patient (47.2%). According to patients’ opinions, doctors frequently neglected key aspects of communication, such as encouraging them to ask questions (28.4%), involving them in shared decision making (29.2%) and discussing the next steps of treatment (35.2%) [22]. These aspects can be classified as elements related to Giving and Receiving Feedback, which in this study also emerged as an area requiring improvement.

Listening was identified as the weakest communication skill among the surveyed general practitioners. Research indicates that some general practitioners struggle with active listening. Engaging in active and reflective listening requires general practitioners to attend to the emotional and personal aspects of a patient’s condition [23]. Effective listening, along with sufficient time dedicated to it, positively impacts accurate information exchange, verification, and socio-emotional communication in healthcare settings [24]. Patients highly value being heard, taken seriously and understood. Medical professionals should not only attend to physical symptoms but also acknowledge patients’ emotions and the broader context of their concerns. However, listening as a clinical skill remains largely neglected in medical training. Existing communication programmes primarily emphasise what to say rather than how to listen [25].

Depending on the specific area of communication skills assessed, factors influencing the observed differences in results included: gender, age, years of experience, self-assessment of communication skills, perception of the adequacy of consultation time, the perceived need for practical communication training and participation in training programmes that support patient-doctor communication.

The study showed that female general practitioners achieved significantly higher scores in Giving and Receiving Feedback, compared to their male counterparts. Other studies also suggest that female doctors tend to be more empathetic and possess better communication skills than males. This aligns with the current findings, where female general practitioners were noted to better empathise with patients’ situations, understand their concerns, listen patiently and respond effectively [8]. In primary care, female practitioners are often expected to spend more time with patients, pay more attention to them and display greater empathy. This is because women are socially perceived as more nurturing, caring and expressive, compared to men. On the other hand, male communication styles tend to be more direct and task-oriented, with expectations that they will demonstrate authority and leadership, which may make it harder for patients to ask questions. However, this approach can sometimes be seen as distant and indifferent, potentially hindering effective patient-doctor communication and shared decision making [26, 27].

In this study, general practitioners who rated the consultation time with patients as insufficient demonstrated better communication skills in three out of four areas: Sending Clear Messages, Giving and Receiving Feedback and Listening. It appears that consultation time plays a crucial role in patient-doctor communication. Doctors who spent three additional minutes per consultation showing interest and asking about patients’ family and well-being were perceived as having better communication skills compared to those who consulted in a shorter time frame [28–30]. Furthermore, short consultations were found to contribute to polypharmacy, antibiotic overuse and poor patient-doctor communication [30]. Doctors with shorter consultations also reported higher levels of burnout, due to a lack of personal achievement and a sense of lower productivity, especially in the context of treating patients with multimorbidity.

This study found that medical professionals with longer years of experience demonstrated better communication skills, but only in the area of Sending Clear Messages, compared to those with less experience. No significant differences were observed in other communication areas in relation to years of practice. Interesting findings were reported in the study by Kruse et al., which revealed that medical students with significantly less professional experience exhibited higher levels of empathy than experienced doctors. This suggests a decline in perceived empathy as professional experience increases [31].

Conversely, another study indicated that greater professional experience was associated with improved communication skills [32]. In the same study, however, no association was found between respondents’ age and their communication skills. This result contrasts with our own findings, as older practitioners demonstrated better communication skills compared to younger doctors, specifically in Sending Clear Messages. Results regarding the influence of age and professional experience on communication are inconsistent across studies. For example, another study highlighted that younger doctors excelled in two key areas: obtaining and providing information and discussing subsequent treatment steps with patients. Greater experience does not necessarily lead to better communication skills. Older doctors, who have been in practice longer, may be more prone to emotional burnout. Therefore, although they have more experience in patient-doctor communication, they may not necessarily communicate more effectively [33].

In all four areas of communication skills examined, overall self-assessment of communication skills proved to be a significant factor. Interestingly, the results suggest that the surveyed doctors were not fully aware of their communication abilities. This contrasts with other research findings, where doctors tend to overestimate their communication skills [34]. This discrepancy may be attributed to differing perspectives between patients and doctors regarding what constitutes effective communication. Patients often favour a psychosocial model of communication, while doctors more commonly apply the biomedical model [35].

Scientific literature highlights the importance of intensively training patient-doctor communication skills, both during undergraduate medical education and throughout postgraduate training [1]. Our study found that respondents who reported no need for further communication training scored lower in communication skills, particularly in Handling Emotional Interactions. Although communication skills are influenced by various personal factors, research indicates that these abilities can be enhanced through targeted training and experience [2].

Building on the communication findings of this study, the results indicate a clear need for systemic changes in Poland and across Europe that place greater emphasis on the quality of health communication, patient education, and shared understanding as integral components of prevention strategies. Strengthening clinicians’ communication competencies and ensuring sufficient time and structural support for meaningful interactions between patients and clinicians are closely aligned with the recommendations of the European Program for Prevention (EPP), which calls for the immediate implementation of proven, evidence-based preventive measures within routine care [36]. In this context, health education is a critical tool for improving health literacy, supporting fact-based decision making, and countering misinformation and disinformation, thereby enhancing trust and patient experience, an effect also observed with supportive services in hospital care [37]. To make these gains durable, periodic training in communication should be mandated and repeated as part of compulsory professional training required of medical personnel, with protected time and organizational support; repeated training also strengthens clinical effectiveness by improving adherence, safety, and outcomes. Taken together, these findings both support and can be further reinforced by the EU Safe Hearts Plan, as they highlight communication and education as foundational enablers of effective cardiovascular prevention, while coordinated EU level initiatives provide a structural framework that amplifies the implementation of EPP principles through consistent, communication-centred preventive policies.

The main limitation of the study is that data were obtained solely through self-reporting by doctors, which introduces the risk of systematic bias, particularly self-assessment bias and social desirability bias. Physicians may overestimate their communication skills or respond in ways they perceive as socially acceptable, rather than providing an accurate reflection of their behaviour. Interestingly, the results revealed that doctors who rated their communication skills as poor or very poor actually achieved higher objective scores, potentially indicating the presence of the reverse Dunning-Kruger effect – where more competent individuals are more critical of their own abilities. To enrich the findings, it would be valuable to include the perspective of patients regarding doctors’ communication skills. Additionally, the study considered a limited range of factors that may influence doctor-patient communication. Given the complex and multifaceted nature of this interpersonal dynamic, further research could broaden the analysis by exploring personal factors that may affect doctor-patient communication.

In conclusion, the results suggest that the surveyed doctors may lack full awareness of their communication skills. This highlights the need for the introduction of standardised diagnostic assessments in this area, alongside the implementation of targeted training programmes focusing on patient-doctor communication. The results may have broader relevance for primary care systems where physician-patient communication is a key determinant of care quality.