title: At the intersection of micro and macro: opportunities and challenges for physician-patient communication research.
abstract: The health care relationship model is undergoing dramatic change. Micro-level communication patterns yield health care relationship models (e.g. paternalism, mutual participation, consumerism). At the same time, macro-level systems appear increasingly likely to influence the nature of micro-level interaction. The intersections of health care communication micro-level and macro-level phenomena provide important venues for research and interventions. This essay identifies theoretical premises regarding the relationships between communication and health-related behavior; explores three prominent and growing macro-level phenomena that observers argue likely influence the physical-patient relationship and communication therein: complementary and alternative medicine, the Internet, and direct-to-consumer advertising of prescription drugs; and offers a research agenda for exploring macro-level influences on micro-level physician-patient communication.
authors.affiliation: Department of Health Science Education, University of Florida, Gainesville, FL 32611, USA. rcline@hhp.ufl.edu
authors.forename: Rebecca J Welch
authors.initials: RJ
authors.lastname: Cline
mesh_terms: D000329:Advertising; D001318:Authoritarianism; D003142:Communication; D000529:Complementary Therapies; D003299:Cooperative Behavior; D004345:Drug Industry; D015438:Health Behavior; D006801:Humans; D020407:Internet; D008960:Models, Psychological; D010358:Patient Participation; D010817:Physician-Patient Relations; D012106:Research / Q000458:organization & administration*