Received from the Program in Medical Ethics (SLS, SB, PZ, MW, DCR, BL) and Division of General Internal Medicine (SLS, BL), University of California, San Francisco, Calif; and Department of Medicine (DCR), University of Washington, Seattle, Wash.
Do Patients Really Prefer It?
Article first published online: 12 NOV 2004
Journal of General Internal Medicine
Volume 19, Issue 11, pages 1069–1079, November 2004
How to Cite
Swenson, S. L., Buell, S., Zettler, P., White, M., Ruston, D. C. and Lo, B. (2004), Patient-centered Communication. Journal of General Internal Medicine, 19: 1069–1079. doi: 10.1111/j.1525-1497.2004.30384.x
Presented in part at the 25th annual meeting of the Society of General Internal Medicine in Atlanta, Ga, May 2, 2002.
- Issue published online: 12 NOV 2004
- Article first published online: 12 NOV 2004
- patient-centered care;
- physician-patient relations;
- comparative study;
- patient satisfaction
OBJECTIVE: To investigate patient preferences for a patient-centered or a biomedical communication style.
DESIGN: Randomized study.
SETTING: Urgent care and ambulatory medicine clinics in an academic medical center.
PARTICIPANTS: We recruited 250 English-speaking adult patients, excluding patients whose medical illnesses prevented evaluation of the study intervention.
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.
MEASUREMENTS AND MAIN RESULTS: 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.”
CONCLUSIONS: 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.