What Matters in the Primary Care Relationship? Comparing General Practitioners' and Patients' Narratives

Abstract Background. There is still limited clarity regarding which components of the physician–patient relationship (PPR) are most valued by patients,and only a few studies have examined physicians’ perspectives on what constitutes a high-quality PPR in the context of primary care. This study investigates how general practitioners (GPs) and patients represent PPR, focusing on the core dimensions of meanings that shape their mutual expectations and perceptions. Methods. In-depth semi-structured interviews were conducted with 28 GPs (meanage: 52.93 ± 14.641; women: 35.7%) and 37 patients (mean age: 36.08 ±15.049; women: 59.5%). An automatic, context-sensitive, semantic analysis was applied to the verbatim transcripts of the interviews to identify the two main dimensions determining similarities and dissimilarities in the interviewees’ narratives. The results. The first dimension opposes a technical-organizational focus, foregrounding core clinical tasks of diagnosis and treatment, along with organizational constraints, and a relational one, foregrounding the need for mutual recognition and emotional attunement in the PPR. The second dimension contrastsa representation of the GP as a diagnostic guide, marked by a comprehensive understanding that integrates biomedical information with the patient's psychosocial background, with one of the GP as a friendly figure, providing emotional closeness, warmth and immediate availability.Interestingly, older patients and younger GPs tend to align with the diagnosticand guiding functions, whereas younger patients and older GPs gravitate toward the friendliness function – an asymmetry that reveals a nuanced interplay of generational, cultural, and relational dynamics within the PPR. Conclusions. Discrepancies in how GPs and patients perceive and frame the PPR could contribute to mutual misunderstanding or unmet expectations if not acknowledged and addressed. Promoting strategies that help GPs adapt their stance on the basis of context, patientpreferences, and the evolving nature of the relationship could enhance the quality of engagement and reduce misalignment.