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Patient-Centered Communication

Quality communication between physicians and patients is critical to improving and maintaining positive health care. Research indicates that when physicians fail to be adequately responsive to patients’ issues or concerns, it may lead patients to feel more like objects than human beings. Conversely, more positive relations and heightened understanding between doctors and patients can lead to a range of positive outcomes, including higher levels of treatment adherence, patient satisfaction, decreased malpractice claims, and overall better patient health outcomes. Given the link between positive doctor–patient relations and improved health, substantial research exists aimed at identifying methods for improving interactions occurring between physicians and patients. Of the varied approaches employed during medical visits, communication and public health researchers frequently promote the use of more patient-centered communication strategies.

This communication style involves physicians incorporating patients’ feelings, expectations, and beliefs regarding an illness into the medical interview. Physicians employing this approach perceive the patient as a whole person within their social and psychological context. In addition, scholars note that patient-centered communication includes an understanding of both the patient’s expectations and feelings, as well as the patient’s broader perceptions of his or her social context. Furthermore, this communication style aims to reach a shared understanding between physicians and patients and to ultimately empower patients by involving them in a shared decision-making process.

The patient-centered style contrasts with a traditional biomedical communication model. In biomedical models, physicians are the primary communication participants/actors, driving the flow of the interaction as well as choosing the specific conversational topics. Employing a patient-centered communication style as opposed to a biomedical approach can promote greater patient satisfaction, as well as more positive functional and biomedical outcomes. In contrast, failure to adopt a patient-centered communication approach predicts greater persistence of symptoms. This entry examines factors that contribute to the use of patient-centered communication and further examines methods for studying and measuring the impact of patient-centered communication.

Factors Contributing to Use and Preference

It is worth noting that numerous individual and contextual elements may explain preference for patient-centered communication styles. For example, certain groups (particularly those who are older) may prefer a more direct communication style. The Institute of Medicine notes that four different factors—patient, health system, relationship, and clinician—influence patient-centered communication. Consequently, these four factors may all be more or less patient-centered. Issues such as emotional distress (patient factors), access to care (health systems factor), trust (relationship factor) and a patient-centered orientation (clinician factor) may influence the level of patient-centered communication. Furthermore, this model suggests that patient-centered communication is not strictly defined as a distinct feature of a particular physician, but rather is a quality of the larger health care system. Although there is substantial evidence supporting the positive impact of patient-centered communication, the overall effectiveness of this approach remains somewhat unclear. Given these findings, researchers have argued that it may be best to match patient preferences with a physician’s communication style.

Measuring Patient-Centered Communication

Patient-centered communication encompasses both a style/practice (trait) as well as the behaviors occurring during a unique interaction (state). As such, patient-centered communication may reflect numerous attitudes and behaviors. Given these assumptions, it is often challenging to pinpoint specific concepts or broader theories/models to draw on when measuring components of patient-centered communication. Consequently, a range of qualitative and quantitative methodologies is utilized to assess distinct components of doctor–patient interactions. The following sections outline the most frequent utilized approaches to assess patient-centered communication.

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