The clinician-patient partnership paradigm: outcomes associated with physician communication behavior.
OBJECTIVE
To identify physician communication behaviors associated with perceptions of quality of care and predictive of positive patient outcomes.


METHODS
A total of 452 families seeing 48 pediatricians for a child's asthma participated. Perceptions and health care use were assessed at baseline and after 12 months through interviews and medical records. The measures used were 10 physician communication behaviors and 6 items describing physician's performance, asthma office visits, emergency department visits, and hospitalization.


RESULTS
Positive perceptions of physicians' performance were related to (P < or = .05) careful listening, inquiring about at-home management, nonverbal attention, interactive conversation, tailoring short-term goals, and long-term therapeutic plan. Loss in health care use was predicted (P < or = .05) by interactive conversation, short-term goals, criteria for decision making, long-term treatment plan, and tailoring according to needs. The use of these techniques did not lengthen the patient visit. A clinician-patient partnership paradigm is provided based on these findings.


CONCLUSIONS
The specific clinician communication behaviors predicted reduced health care use and positive perceptions of quality of care.
Clark
Noreen M
NM
Center for Managing Chronic Disease University of Michigan, Ann Arbor, MI 48109-2029, USA. nmclark@umich.edu
Cabana
Michael D
MD
Nan
Bin
B
Gong
Z Molly
ZM
Slish
Kathryn K
KK
Birk
Nancy A
NA
Kaciroti
Niko
N
D001249:Asthma; D002648:Child; D002675:Child, Preschool; D003142:Communication; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D010290:Parents / Q000523:psychology*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011787:Quality of Health Care