title: Physician empathy and listening: associations with patient satisfaction and autonomy.
abstract: OBJECTIVE
  Motivational Interviewing (MI) is used to help patients change their behaviors. We sought to determine if physician use of specific MI techniques increases patient satisfaction with the physician and perceived autonomy.
  
  
  METHODS
  We audio-recorded preventive and chronic care encounters between 40 primary care physicians and 320 of their overweight or obese patients. We coded use of MI techniques (eg, empathy, reflective listening). We assessed patient satisfaction and how much the patient felt the physician supported him or her to change. Generalized estimating equation models with logit links were used to examine associations between MI techniques and patient perceived autonomy and satisfaction.
  
  
  RESULTS
  Patients whose physicians were rated as more empathic had higher rates of high satisfaction than patients whose physicians were less empathic (29% vs 11%; P = .004). Patients whose physicians made any reflective statements had higher rates of high autonomy support than those whose physicians did not (46% vs 30%; P = .006).
  
  
  CONCLUSIONS
  When physicians used reflective statements, patients were more likely to perceive high autonomy support. When physicians were empathic, patients were more likely to report high satisfaction with the physician. These results suggest that physician training in MI techniques could potentially improve patient perceptions and outcomes.
authors.affiliation: Cancer Prevention, Detection, and Control Research Program, Duke University Medical Center, Durham, NC, USA. Kathryn.pollak@duke.edu
authors.forename: Kathryn I
authors.initials: KI
authors.lastname: Pollak
authors.forename: Stewart C
authors.initials: SC
authors.lastname: Alexander
authors.forename: James A
authors.initials: JA
authors.lastname: Tulsky
authors.forename: Pauline
authors.initials: P
authors.lastname: Lyna
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Coffman
authors.forename: Rowena J
authors.initials: RJ
authors.lastname: Dolor
authors.forename: Pål
authors.initials: P
authors.lastname: Gulbrandsen
authors.forename: Truls
authors.initials: T
authors.lastname: Ostbye
mesh_terms: D000368:Aged; D003376:Counseling / Q000379:methods*; D004645:Empathy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009042:Motivation; D009765:Obesity / Q000523:psychology / Q000628:therapy; D050177:Overweight / Q000523:psychology / Q000628:therapy*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D011320:Primary Health Care
references.citation: Am J Health Promot. 2007 Jul-Aug;21(6):498-500
references.pmid: 17674636
references.citation: J Subst Abuse Treat. 2005 Jan;28(1):19-26
references.pmid: 15723728
references.citation: JAMA. 1999 Oct 27;282(16):1576-8
references.pmid: 10546698
references.citation: Addict Behav. 2007 Oct;32(10):2297-303
references.pmid: 17307300
references.citation: BMC Fam Pract. 2006 Jun 06;7:35
references.pmid: 16756673
references.citation: Soc Sci Med. 2006 May;62(10):2458-68
references.pmid: 16376006
references.citation: Patient Educ Couns. 2007 Aug;67(3):333-42
references.pmid: 17574367
references.citation: Patient Educ Couns. 2003 Nov;51(3):197-206
references.pmid: 14630376
references.citation: Br J Clin Psychol. 2006 Mar;45(Pt 1):63-82
references.pmid: 16480567
references.citation: Arch Pediatr Adolesc Med. 2007 May;161(5):495-501
references.pmid: 17485627
references.citation: CMAJ. 1995 May 1;152(9):1423-33
references.pmid: 7728691
references.citation: Can J Psychiatry. 1995 Mar;40(2):60-6
references.pmid: 7788619
references.citation: Psychol Bull. 1979 Mar;86(2):420-8
references.pmid: 18839484
references.citation: Am J Prev Med. 2010 Oct;39(4):321-8
references.pmid: 20837282
references.citation: J Pers Soc Psychol. 1996 Jan;70(1):115-26
references.pmid: 8558405
references.citation: Am J Prev Med. 2001 Jan;20(1):68-74
references.pmid: 11137778
references.citation: J Subst Abuse Treat. 2007 Jan;32(1):11-7
references.pmid: 17175394
references.citation: JAMA. 1997 Feb 19;277(7):553-9
references.pmid: 9032162
references.citation: Patient Educ Couns. 2011 Dec;85(3):363-8
references.pmid: 21316897
references.citation: Eur J Cardiovasc Prev Rehabil. 2006 Apr;13(2):222-8
references.pmid: 16575276
references.citation: J Clin Oncol. 1999 Jan;17(1):371-9
references.pmid: 10458256
references.citation: JAMA. 1993 Aug 18;270(7):835-40
references.pmid: 8340982
references.citation: J Fam Pract. 2007 Dec;56(12):1031-6
references.pmid: 18053443