Identification of cultural determinants of antibiotic use cited in primary care in Europe: a mixed research synthesis study of integrated design “Culture is all around us”

Table 2 Influence of power distance within the medical consultation in primary care

High	Low	References
Patients look up to the GP.	Patients see themselves as equal to the GP.	[12]
Less shared decision making: “Doctor knows best” attitude (Less discussion, information, counselling and negotiation during the consultation).	More shared decision making (more discussions, information, counselling and negotiation in the consultation).	[12, 20, 28]
GP cannot acknowledge he is unsure of diagnosis (fear of inspiring less confidence).	GP can acknowledge he is unsure of diagnosis (inspires confidence anyway).	[12]
Antibiotic prescription symbolic sign of power and expertise.	Antibiotic has a less symbolic importance.	[12]

ISSN: 1471-2458