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Patient-centered communication

Do patients really prefer it?

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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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Authors and Affiliations

  1. the Program in Medical Ethics, University of California, San Francisco, Calif

    Sara L. Swenson MD, Stephanie Buell BA, Patti Zettler BA, Martha White BS, Delaney C. Ruston MD & Bernard Lo MD

  2. Division of General Internal Medicine, University of California, San Francisco, Calif

    Sara L. Swenson MD & Bernard Lo MD

  3. Department of Medicine, University of Washington, Seattle, Wash

    Delaney C. Ruston MD

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  1. Sara L. Swenson MD
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  2. Stephanie Buell BA
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  3. Patti Zettler BA
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  4. Martha White BS
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Corresponding author

Correspondence to Sara L. Swenson MD.

Additional information

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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