Abstract
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 non-users; 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.
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This work was supported by the Robert Wood Johnson Foundation Initiative on Strengthening the Patient-Provider Relationship.
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Swenson, S.L., Buell, S., Zettler, P. et al. Patient-centered communication. J GEN INTERN MED 19, 1069–1079 (2004). https://doi.org/10.1111/j.1525-1497.2004.30384.x
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DOI: https://doi.org/10.1111/j.1525-1497.2004.30384.x