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First, given the previously found decline in empathy by GPs over time, we expect to find a decline in expression of concerns or cues to underlying concerns by patients during recent consultations.
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Furthermore, we found that late-arising concerns were common in our study sample and were even more likely during more recent consultations.
Our study shows that patients are likely to express their worries during primary care psychosocial consultations and that the proportion of consultations with at least one explicit concern was higher during more recent consultations.
In a recent comparison between consultations prior to and after the implementation in the 1990s of national clinical guidelines in the Netherlands, general practitioners (GPs) showed less empathy during more recent consultations considered psychosocial by GPs as compared to similar consultations from the 1980s [ 1].
But when lots of businesses spoke out in favour of the scheme during a recent consultation process, Aviva was not among them.
However, unions representing the NHS's 400,000 nurses responded cautiously to the idea, which emerged during a recent consultation run by HEE, which spends £5bn a year ensuring that the NHS has the workforce it needs.
Patients more often expressed cues and concerns during the last phase of information and advice in more recent consultations (see Table 2).
Late arising cues and concerns were more likely in recent consultations, compared to older consultations.
In this study we used GPs' own recent consultations as cues for stimulated recall stimulating GPs to reflect on what really happened during their patient encounters, thereby reducing the chance of incomplete, unreliable, or unfeasible answers.
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Since I tried Ludwig back in 2017, I have been constantly using it in both editing and translation. Ever since, I suggest it to my translators at ProSciEditing.

Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com