A novel analytical strategy for patient-physician communication research: the one-with-many design.

Abstract

OBJECTIVE: We aimed to demonstrate how a novel analytic strategy - the one-with-many (OWM) design - can provide unique information about patient-physician communication that cannot be obtained using traditional analytic strategies. METHODS: Using an OWM design we conducted a secondary analysis of behavioral (talk time) and self-reported (perceived teamness) data from a study of patient-physician communication, and examined variance decompositions of these variables. RESULTS: Talk time was largely relational, suggesting that there is no behavioral consistency on the part of physicians across patients or behavioral similarity among patients who see the same physician. In contrast, there was significant actor variance in perceived teamness, suggesting that some physicians consistently reported higher teamness with their patients than others. However, those physicians' positive perceptions of the communication are not necessarily reciprocated by their patients. CONCLUSIONS: OWM design provides researchers with the opportunity to take full advantage of rich non-independent data and explore interesting communication patterns (e.g., behavioral continuity, similarity, reciprocity unique to specific dyads) that have been omitted in prior literature. PRACTICAL IMPLICATIONS: OWM can be used to determine the relative differences in how patients and physicians influence communication patterns and identify which aspects of physician-patient communication are relational and which are not.