title: Medical specialists' patient-centered communication and patient-reported outcomes.
abstract: BACKGROUND
  Physicians' patient-centered communication in the medical consultation is generally expected to improve patient outcomes. However, empirical evidence is contradictory so far, and most studies were done in primary care.
  
  
  OBJECTIVE
  We sought to determine the association of specialists' patient-centered communication with patient satisfaction, adherence, and health status.
  
  
  METHODS
  Residents and specialists in internal medicine (n = 30) and their patients (n = 323) completed a questionnaire before a (videotaped) follow-up encounter. Patients' satisfaction was assessed immediately after the consultation and their self-reported treatment adherence, symptoms, and distress 2 weeks later. Specialists' patient-centered communication was assessed by coding behaviors that facilitate or rather inhibit patients to express their perspective. Patient participation was assessed by determining their relative contribution to the conversation and their active participation behavior. Outcomes were assessed using standard questionnaires. Analyses accounted for relevant patient, visit and physician characteristics.
  
  
  CONCLUSIONS
  Medical specialists' facilitating behavior was associated with greater satisfaction in patients who were less confident in communicating with their doctor. Patient-centered communication was not associated with patients' health status or adherence in general, but facilitating behavior was positively related to the adherence of patients with a foreign primary language. In general, patients appeared to be more satisfied after an encounter with a more-facilitating and a less-inhibiting physician, but these associations diminished when controlling for background characteristics. We conclude that the absence of strong associations between patient-centered communication and patient-reported outcomes may be explained by medical specialists being responsive to patients' characteristics.
authors.affiliation: Department of Medical Psychology, Academic Medical Center/University of Amsterdam, The Netherlands. L.C.Zandbelt@amc.uva.nl
authors.forename: Linda C
authors.initials: LC
authors.lastname: Zandbelt
authors.forename: Ellen M A
authors.initials: EM
authors.lastname: Smets
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Oort
authors.forename: Mieke H
authors.initials: MH
authors.lastname: Godfried
authors.forename: Hanneke C J M
authors.initials: HC
authors.lastname: de Haes
mesh_terms: D000328:Adult; D003142:Communication; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008511:Medicine; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D011369:Professional-Patient Relations; D012650:Self Disclosure; D013038:Specialization; D011795:Surveys and Questionnaires