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


CONCLUSIONS
Better understanding the diversity of patient communication preferences may lead to more effective and individualized care.
Swenson
Sara L
SL
Program in Medical Ethics at the University of California, Box 0320, 400 Parnassus Avenue, San Francisco, CA 94143-0320, USA. swenson@medicine.ucsf.edu
Zettler
Patti
P
Lo
Bernard
B
D000328:Adult; D001294:Attitude to Health; D001318:Authoritarianism; D002755:Choice Behavior; D002983:Clinical Competence / Q000592:standards; D003142:Communication; D003299:Cooperative Behavior; D004645:Empathy; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D015404:Nursing Methodology Research; D018802:Patient-Centered Care / Q000458:organization & administration*; D010819:Physician's Role / Q000523:psychology; D010817:Physician-Patient Relations; D036301:Qualitative Research; D012495:San Francisco; D011795:Surveys and Questionnaires; D035502:Trust; D014342:Truth Disclosure; D014743:Videotape Recording