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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    • "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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    • "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). "
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