The Clinician-Patient Partnership Paradigm: Outcomes Associated With Physician Communication Behavior

Abstract

Objective: To identify physician communication behaviors associated with perceptions of quality of care and predictive of positive patient outcomes. Patients and Methods: A total of 452 families seeing 48 pediatricians for a child's asthma participated. Perceptions and health care use were assessed at baseline and after 12 months through interviews and medical records. The measures used were 10 physician communication behaviors and 6 items describing physician's performance, asthma office visits, emergency department visits, and hospitalization. Results: Positive perceptions of physicians' performance were related to ( P ≤ .05) careful listening, inquiring about at-home management, nonverbal attention, interactive conversation, tailoring short-term goals, and long-term therapeutic plan. Loss in health care use was predicted ( P ≤ .05) by interactive conversation, short-term goals, criteria for decision making, long-term treatment plan, and tailoring according to needs. The use of these techniques did not lengthen the patient visit. A clinician-patient partnership paradigm is provided based on these findings. Conclusions: The specific clinician communication behaviors predicted reduced health care use and positive perceptions of quality of care.