title: Physicians, nonphysician healthcare providers, and patients communicating in hepatitis C: an in-office sociolinguistic study.
abstract: In-office conversations about hepatitis C can impact patients' perceptions of outcomes, as well as medication adherence. This study analyzed interactions between physicians, nonphysician healthcare providers (including nurses), and patients with hepatitis C virus infection in order to examine differences based on number and type of providers participating. Gastroenterologists, nonphysician healthcare providers, and patients with hepatitis C virus infection were video- and audio-recorded during regularly scheduled visits. Recordings were transcribed and analyzed using validated sociolinguistic techniques. Thirty-four visits took place with a physician only, 4 with a nonphysician healthcare provider only, and 25 with both providers (9 concurrent and 16 consecutive). Differences among the participant schema included visit length, patient "talk-time," and motivation provided. When providers saw patients consecutively, differing information was sometimes provided. In visits where providers saw the patient concurrently, competing authority between providers and exclusion of the patient through use of medical jargon were obstacles to ideal communication. Differences in hepatitis C-related interactions based on the number and type of participants suggest opportunities for improved communication. In visits with multiple providers, physicians and nurses should attempt to ensure that they (a) avoid supplying differing information, (b) present a "unified front" to avoid competing authority, and (c) minimize the use of medical jargon, which excludes patients from participating in their own healthcare.
authors.affiliation: Department of Linguistics, Georgetown University, Washington, DC, USA.
authors.forename: Heidi E
authors.initials: HE
authors.lastname: Hamilton
authors.forename: Cynthia
authors.initials: C
authors.lastname: Gordon
authors.forename: Meaghan
authors.initials: M
authors.lastname: Nelson
authors.forename: Marian
authors.initials: M
authors.lastname: Kerbleski
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003142:Communication; D005260:Female; D005762:Gastroenterology; D006526:Hepatitis C / Q000188:drug therapy / Q000523:psychology* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009722:Nurse Practitioners / Q000523:psychology; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000523:psychology*; D009743:Nursing, Practical; D009819:Office Visits; D010353:Patient Education as Topic; D010823:Physician Assistants / Q000523:psychology; D010820:Physicians / Q000523:psychology*; D024382:Professional Role / Q000523:psychology; D011369:Professional-Patient Relations; D011578:Psycholinguistics; D013637:Tape Recording; D013996:Time and Motion Studies; D014481:United States; D014743:Videotape Recording