The Communication Patterns of Internal Medicine and Family Practice Physicians

Paasche‐Orlow, Michael K.; Roter, Debra

doi:10.3122/jabfm.16.6.485

Cited by 67 publications

(48 citation statements)

References 26 publications

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“…The mean number of statements from clinicians was 256.7 (SD, 99.0) compared with 154.3 from patients (SD, 70.7). Visit duration and the frequency of patient statements were similar to that of prior studies of primary care visits in the United States, 43,44 but the frequency of clinician statements were somewhat greater (256.7 vs 176.3). 44 At 1-month follow-up, 83 patients (86%) were reachable by telephone.…”

Section: Resultssupporting

confidence: 67%

The Effects of Patient-Provider Communication on 3-Month Recovery from Acute Low Back Pain

Shaw

Pransky

Roter

et al. 2011

The Journal of the American Board of Family Medicine

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Background: Patient-provider communication has been indicated as a key factor in early recovery from acute low back pain (LBP), one of the most common maladies seen in primary care; however, associations between communication and LBP outcomes have not been studied prospectively.Methods: Working adults (n ‫؍‬ 97; 64% men; median age, 38 years) with acute LBP completed baseline surveys, agreed to audio recording of provider visits, and were followed for 3 months. Using the Roter Interaction Analysis System, 10 composite indices of communication were compared with 1-and 3-month patient outcomes.Results

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Section: Resultssupporting

confidence: 67%

The Effects of Patient-Provider Communication on 3-Month Recovery from Acute Low Back Pain

Shaw

Pransky

Roter

et al. 2011

The Journal of the American Board of Family Medicine

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“…Few data exist on actual cross-cultural clinical practices of family medicine residents or attending practitioners compared to other physicians. To obtain a more objective measurement, some researchers have audiotaped clinical interactions of PCPs and minority patients, 24 whereas others have surveyed patients directly via telephone regarding perceptions of bias and cultural competence among PCPs. 38 Observational assessments, such as audio recordings, and secondary evaluations from patients and/or resident supervisors would help to reduce self-reported biases.…”

Section: Discussionmentioning

confidence: 99%

“…[21][22][23] Consistent with these educational values, empirical findings demonstrate that family practitioners tend to be more patient-centered in their communication style with minority patients when compared to internal medicine physicians. 24 Furthermore, family medicine trainees are more likely than internal medicine trainees to rate sociocultural factors as relevant to clinical practice and to perceive themselves as more competent in managing sociocultural issues. 25 Formal preparation for providing cross-cultural care among pediatric and obstetrics/gynecology (OB/GYN) residents is more difficult to characterize from previous research.…”

Section: Introductionmentioning

confidence: 99%

Primary Care Resident Perceived Preparedness to Deliver Cross-cultural Care: An Examination of Training and Specialty Differences

et al. 2007

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OBJECTIVE:Previous research has shown that resident physicians report differences in training across primary care specialties, although limited data exist on education in delivering cross-cultural care. The goals of this study were to identify factors that relate to primary care residents' perceived preparedness to provide crosscultural care and to explore the extent to which these perceptions vary across primary care specialties. DESIGN:Cross-sectional, national mail survey of resident physicians in their last year of training. PARTICIPANTS:Eleven hundred fifty primary care residents specializing in family medicine (27%), internal medicine (23%), pediatrics (26%), and obstetrics/gynecology (OB/GYN) (24%). RESULTS:Male residents as well as those who reported having graduated from U.S. medical schools, access to role models, and a greater cross-cultural case mix during residency felt more prepared to deliver crosscultural care. Adjusting for these demographic and clinical factors, family practice residents were significantly more likely to feel prepared to deliver crosscultural care compared to internal medicine, pediatric, and OB/GYN residents. Yet, when the quantity of instruction residents reported receiving to deliver cross-cultural care was added as a predictor, specialty differences became nonsignificant, suggesting that training opportunities better account for the variability in perceived preparedness than specialty.CONCLUSIONS: Across primary care specialties, residents reported different perceptions of preparedness to deliver cross-cultural care. However, this variation was more strongly related to training factors, such as the amount of instruction physicians received to deliver such care, rather than specialty affiliation. These findings underscore the importance of formal education to enhance residents' preparedness to provide cross-cultural care.

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“…Some physicians as a matter of routine provide more information, use more partnership-building, are more supportive, and are more willing to talk about psychosocial topics than are other doctors (Roter, Stewart, Putnam, Lipkin, Stiles & Inui, 1997;Street, 1991a;Street, 1992b;Zandbelt, Smets, Oort, Godfried & de Haes, 2006). A physician's style of communicating with patients may have evolved from repeated experiences with certain kinds of patients, his or her philosophy of care (Krupat, Rosenkranz, Yeager, Barnard, Putnam & Inui, 2000;Levinson & Roter, 1995), or socialization related to gender (Bertakis, Helms, Callahan, Azari & Robbins, 1995;Hall & Roter, 1998), culture (Waitzkin, 1985), and medical training (Bertakis, Callahan, Helms, Azari, Robbins & Miller, 1998;Bertakis, Helms, Azari, Callahan, Robbins & Miller, 1999;Paasche-Orlow & Roter, 2003). In this investigation, we were particularly interested in whether physicians' communication and perceptions were related to their orientations to the provider-patient relationship (Haidet, Dains, Paterniti, Hechtel, Chang, Tseng et al 2002;Krupat, Bell, Kravitz, Thom & Azari, 2001;Krupat, Hiam, Fleming & Freeman, 1999).…”

Section: Conceptual Framework: An Ecological Approachmentioning

confidence: 99%

Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor?

Street

Gordon

Haidet

2007

Social Science & Medicine

449

359

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Although physicians' communication style and perceptions affect outcomes, few studies have examined how these perceptions relate to the way physicians communicate with patients. Moreover, while any number of factors may affect the communication process, few studies have analyzed these effects collectively in order to identify the most powerful influences on physician communication and perceptions. Adopting an ecological approach, this investigation examined: (a) the relationships of physicians' patient-centered communication (informative, supportive, partnership-building) and affect (positive, contentious) on their perceptions of the patient, and (b) the degree to which communication and perceptions were affected by the physicians' characteristics, patients' demographic characteristics, physician-patient concordance, and the patient's communication. Physicians (N = 29) and patients (N = 207) from 10 outpatient settings in the United States participated in the study. From audio-recordings of these visits, coders rated the physicians' communication and affect as well as the patients' participation and affect. Doctors were more patientcentered with patients they perceived as better communicators, more satisfied, and more likely to adhere. Physicians displayed more patient-centered communication and more favorably perceived patients who expressed positive affect, were more involved, and who were less contentious. Physicians were more contentious with black patients, whom they also perceived as less effective communicators and less satisfied. Finally, physicians who reported a patient-centered orientation to the doctor-patient relationship also were more patient-centered in their communication. The results suggest that reciprocity and mutual influence have a strong effect on these interactions in that more positive (or negative) communication from one participant leads to similar responses from the other. Physicians' encounters with black patients revealed communicative difficulties that may lower quality of care for these patients.

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The Communication Patterns of Internal Medicine and Family Practice Physicians

Cited by 67 publications

References 26 publications

The Effects of Patient-Provider Communication on 3-Month Recovery from Acute Low Back Pain

The Effects of Patient-Provider Communication on 3-Month Recovery from Acute Low Back Pain

Primary Care Resident Perceived Preparedness to Deliver Cross-cultural Care: An Examination of Training and Specialty Differences

Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor?

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