Patients and doctors have the ability to contribute

to each other their responsibilities. For the patient,

a way to support the doctor in a positive way is by

giving feedback on the care provided. Patient feedback on consultation is becoming more important and appreciated and can play a role in the doctors their development and patient empowerment.


Design has the potential to play a role in reshaping the way of giving feedback and might make feedback more relevant, direct and less time-consuming.


For this reason a patient feedback system called ComMed was created. This gives general practitioners (GPs) the opportunity to receive constructive feedback on consultation, during their consultation. In order to find how GPs experience ComMed and how this can contribute to their development this qualitative study conducted four phases: questionnaire, intervention, questionnaire and interview. From a GP his perspective ComMed can be used as a tool to receive patient feedback on consultation and could potentially enhance self- assessed development.


Responsibility plays a large role in today’s healthcare system; patients have the responsibility to take care of their own health, whereas health care workers have their own responsibilities that can affect the patients their responsibilities. Philosopher Ignaas Devisch [1] proposes a new way of thinking about responsibilities: co-responsibility. This means people have their own responsibilities, however taking care of these responsibilities is affected by society. According to Devisch [1] responsibilities become intertwined and interdependent [2]. In doctor consultation the responsibility of the patient is to recover as best as possible [3,4], the doctor influences this responsibility with elements such as providing help or education on the problem. In the same consultation the responsibility of the doctor is to provide the best care possible [5], the influence of the patient on this responsibility can be enhanced (Fig. 1.). For the patient, a way to support the doctor to be able to provide the best care possible, and therefore enhance co-responsibility in consultation, is by giving feedback on the care provided [6,7,8,9]. Feedback is one of the measures that can improve the doctor-patient relationship. A poor doctor-patient relationship can become a major obstacle for both parties and can affect the quality of care [10]. Furthermore, feedback is widely used as a means of improvement in healthcare [6,11].


Patient feedback on consultation is becoming more important and appreciated and can play a role in the doctors their development and patient empowerment [6,7,8,9]. In order to receive feedback, patient questionnaires are often used. Even though a questionnaire can help identify areas that need improvement, there are several barriers such as interpreting results, support patients to be critical and the amount of time and energy it requires [8,9]. Furthermore physician rating websites exist, however the debate whether such data should be shared on public websites is still ongoing [12,13,14].

This study explores if design can play a role in gathering patient feedback and therewith enhance co-responsibility during consultation. Previous studies have shown that patient feedback leads to improvements in doctors their performance, however improvements are small [6,7,8,9]. Design could play a role in reshaping the way of giving feedback and might make feedback more relevant, direct and less time-consuming. For this reason a design called ComMed (Communication Medicine) was created to give the patient the opportunity to contribute to the general practitioner, henceforth called GP, his development. The aim of this study is to examine how patient feedback through ComMed can enhance the self-assessed development of a GP.



ComMed is a patient feedback system that can be used by GPs in order to receive constructive feedback on the consultation (Fig. 5.). ComMed is placed on the GP his desk in the consulting room and can be used at the end of the consultation. The base consists out of three sections, two green and one blue, on which words can be placed. The green section represents the qualities of the consultation; the blue section represents a point of improvement. The colour blue was chosen for its neutral appearance, this section does not represent something bad (while the colour red would) but something that can be improved. On these sections the patient can place words in order to give feedback about the consultation. A set of seven pre-defined words, describing the ideal character traits of a doctor, is available to choose from. The seven ideal character traits; respectful, confident, humane, thorough, empathetic, personal and forthright, as described by Bendapudi [17] were used.


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2. Neutelings, I., Levy, P., Djajadiningrat, T., Hummels, C. (2017). Enhancing co-responsibility for patient engagement. The Design Journal.

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5. Miles, S. H. (2005). The Hippocratic oath and the ethics of medicine. Oxford University Press.

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8. Wensing, M., Vingerhoets, E., & Grol, R. (2003). Feedback based on patient evaluations: a tool for quality improvement?. Patient education and counseling, 51(2), 149-153.

9. Reinders, M. E., Blankenstein, A. H., van Marwijk, H. W., Schleypen, H., Schoonheim, P. L., & Stalman, W. A. (2008). Development and feasibility of a patient feedback programme to improve consultation skills in general practice training. Patient education and counseling, 72(1), 12-19.

10. Shrivastava, S., Shrivastava, P., & Ramasamy, J. (2014). Exploring the dimensions of doctor-patient relationship in clinical practice in hospital settings.

11. Clynes, M. P., & Raftery, S. E. (2008). Feedback: an essential element of student learning in clinical practice. Nurse Education in practice, 8(6), 405-411.

12. McCartney, M. (2009). Will doctor rating sites improve the quality of care? No. BMJ: British Medical Journal (Online), 338.

13. Bacon, N. (2009). Will doctor rating sites improve standards of care? Yes. BMJ: British Medical Journal (Online), 338.

14. Holliday, A. M., Kachalia, A., Meyer, G. S., & Sequist, T. D. (2017). Physician and patient views on public physician rating websites: a cross-sectional study. Journal of General Internal Medicine, 32(6), 626-631.

17. Bendapudi, N. M., Berry, L. L., Frey, K. A., Parish, J. T., & Rayburn, W. L. (2006, March). Patients' perspectives on ideal physician behaviors. In Mayo Clinic Proceedings (Vol. 81, No. 3, pp. 338-344). Elsevier.