Patient-centered communication: Do patients really prefer it?

Program in Medical Ethics, Division of General Internal Medicine, University of California San Francisco, CA 94143-0320, USA.
Journal of General Internal Medicine (Impact Factor: 3.45). 11/2004; 19(11):1069-79. DOI: 10.1111/j.1525-1497.2004.30384.x
Source: PubMed


To investigate patient preferences for a patient-centered or a biomedical communication style.
Randomized study.
Urgent care and ambulatory medicine clinics in an academic medical center.
We recruited 250 English-speaking adult patients, excluding patients whose medical illnesses prevented evaluation of the study intervention.
Participants watched one of three videotaped scenarios of simulated patient-physician discussions of complementary and alternative medicine (CAM). Each participant watched two versions of the scenario (biomedical vs. patient-centered communication style) and completed written and oral questionnaires to assess outcome measurements.
Main outcome measures were 1) preferences for a patient-centered versus a biomedical communication style; and 2) predictors of communication style preference. Participants who preferred the patient-centered style (69%; 95% confidence interval [CI], 63 to 75) tended to be younger (82% [51/62] for age < 30; 68% [100/148] for ages 30-59; 55% [21/38] for age > 59; P < .03), more educated (76% [54/71] for postcollege education; 73% [94/128] for some college; 49% [23/47] for high school only; P= .003), use CAM (75% [140/188] vs. 55% [33/60] for nonusers; P= .006), and have a patient-centered physician (88% [74/84] vs. 30% [16/54] for those with a biomedical physician; P < .0001). On multivariate analysis, factors independently associated with preferring the patient-centered style included younger age, use of herbal CAM, having a patient-centered physician, and rating a "doctor's interest in you as a person" as "very important."
Given that a significant proportion of patients prefer a biomedical communication style, practicing physicians and medical educators should strive for flexible approaches to physician-patient communication.

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    • "An expectation for extensive receipt of information is contrary to a finding suggesting that a significant proportion of patients prefer the traditional, biomedical communication style (Swenson, Buell, et al. 2004), a focused and " efficient " type of health communication model that only requires short questions and answers. Others have also shown that most patients prefer patient centeredness (Epstein, Franks, et al. 2005). "
    Dataset: 31120549
    • "More unambiguous are reports from observational studies, indicating that the doctor-centered approach is tenacious and that patients still have a limited degree of participation in decision making (Braddock et al., 1999; Campion et al., 2002). Studies also indicate that preferences for being informed and participating in decision making vary amongst patients (de Haes, 2006; Degner and Sloan, 1992; Swenson et al., 2004), and Elwyn et al. (2012, p. 1363) note that: ''Some patients initially decline decisional responsibility role, and are wary about participating''. de Haes (2006) takes a step further by pointing out that patient-centeredness, understood as ''paying attention to psychosocial issues, to stimulate "
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    • "Female physicians spend more time with patients than male physicians do (Roter et al., 2002), and they have more humanistic and patient-centered attitudes about patient care (Krupat et al., 2000). Furthermore, patients generally prefer a patient-centered style (Swenson et al., 2004). However, female physicians do not receive much higher satisfaction ratings from patients—usually, not at all higher—according to a meta-analysis (Hall, Blanch- Hartigan, & Roter, 2011). "
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    ABSTRACT: Previous research suggests that female physicians may not receive appropriate credit in patients' eyes for their patient-centered skills compared to their male counterparts. An experiment was conducted to determine whether a performance of higher (versus lower) verbal patient-centeredness would result in a greater difference in analogue patient satisfaction for male than female physicians. Two male and two female actors portrayed physicians speaking to a patient using high or low patient-centered scripts while not varying their nonverbal cues. One hundred ninety-two students served as analogue patients by assuming the patient role while watching one of the videos and rating their satisfaction and other evaluative responses to the physician. Greater verbal patient-centeredness had a stronger positive effect on satisfaction and evaluations for male than for female physicians. This pattern is consistent with the hypothesis that the different associations between patient-centeredness and patients' satisfaction for male versus female physicians occur because of the overlap between stereotypical female behavior and behaviors that comprise patient-centered medical care. If this is the case, high verbal patient-centered behavior by female physicians is not recognized as a marker of clinical competence, as it is for male physicians, but is rather seen as expected female behavior.
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