RT Journal Article SR Electronic T1 Clinician views on optimism and empathy in primary care consultations: a qualitative interview study JF BJGP Open JO BJGP Open FD Royal College of General Practitioners SP BJGPO.2021.0221 DO 10.3399/BJGPO.2021.0221 VO 6 IS 3 A1 Stephanie Hughes A1 Jane Louise Vennik A1 Kirsten A Smith A1 Jennifer Bostock A1 Jeremy Howick A1 Christian Mallen A1 Paul Little A1 Mohana Ratnapalan A1 Emily Lyness A1 Geraldine M Leydon A1 Hajira Dambha-Miller A1 Leanne Morrison A1 Hazel A Everitt A1 Felicity L Bishop YR 2022 UL http://bjgpopen.org/content/6/3/BJGPO.2021.0221.abstract AB Background Practitioner expressions of optimism and empathy may improve treatment engagement, adherence, and patient satisfaction but are not delivered consistently amid the challenges of everyday clinical practice.Aim To explore primary care practitioner (PCP) views about optimistic and empathic communication in consultations; and to identify behavioural, attitudinal, and/or contextual issues likely to encourage or deter PCPs from practising such communication.Design & setting Qualitative interview study with 20 PCPs (GPs, practice nurses, and primary care physiotherapists).Method Semi-structured telephone interviews with 20 PCPs. Data were analysed thematically.Results A conceptual mismatch between optimism and patient expectations became apparent; when asked how PCPs communicate about the likely effects of a treatment, answers were focussed around managing patient expectations. When prompted, it became clear PCPs were open to communicating optimistically with patients, but emphasised the need for realism. Concerns arose that patients may not be receptive to optimistic messages, especially when holding negative expectations. PCPs felt that expressing empathy is fundamental to all clinical consultations, noting that it can be challenging. Some PCPs worried that increasing expressions of empathy might increase their risk of clinician burnout and felt guilty about (appropriately) communicating empathy while maintaining some emotional distance.Conclusion PCPs agreed expressing realistic optimism during consultations could aid communication and would constitute a novel change to practice. PCPs strive for clinical empathy but can struggle to manage emotional self-protection. Specific training to help PCPs express realistic optimism and empathy, and better utilise efficient non-verbal skills could help these issues.