'She gave it her best shot right away': patient experiences of biomedical and patient-centered communication.

Abstract

OBJECTIVE: Medical educators and researchers recommend a patient-centered interviewing style, but little empirical data exists regarding what aspects of physician communication patients like and why. We investigated patient responses to videotaped doctor-patient vignettes to ascertain what they liked about patient-centered and biomedical communication. METHODS: We conducted semi-structured interviews with 230 adult medicine patients who viewed videotapes depicting both patient-centered and biomedical physician communication styles. We used a mixed methods approach to derive a "ground-up" framework of patient communication preferences. RESULTS: Respondents who preferred different communication styles articulated different sets of values, important physician behaviors, and physician-patient role expectations. Participants who preferred the patient-centered physician (69%) liked that she worked with and respected patients and explored what the patient wanted. Participants who preferred the biomedical physician (31%) liked that she prevented harm, demonstrated medical authority, and delivered information clearly. CONCLUSIONS: Patients like (and dislike) patient-centered communication for thoughtful, considered reasons that appear grounded in their values and expectations about physicians, patients, and the clinical encounter. PRACTICE IMPLICATIONS: Better understanding the diversity of patient communication preferences may lead to more effective and individualized care.