title: Measuring preferred role orientations for patients and providers in veterans administration and university general medicine clinics.
abstract: BACKGROUND
  Congruence between patients' and providers' preferred healthcare role orientations has been shown to be important for improved clinical outcomes and patient satisfaction. Thus, it is important to know how different patient and provider populations might vary in preferred role orientations.
  
  
  OBJECTIVE
  To measure the range of role orientation preferences among patients and providers in two different general medicine clinic populations.
  
  
  METHODS
  Role orientation preferences of patients (n = 319) and providers (n = 151) in six Veterans Administration (VA) primary care clinics and two university-based primary care clinics were measured in a cross sectional survey using the 9-item Patient-Practitioner Orientation Scale (PPOS) sharing subscale among patients and providers.
  
  
  RESULTS
  VA patients had lower mean PPOS scores (i.e. more provider-centered role preference) than the university clinic patients (31.2 vs 39.7, respectively; p < 0.001). The difference remained significant even after adjusting for age, sex, and education. VA and university clinic providers had similar mean PPOS scores (41.5 vs 42.6, respectively; p = 0.27). Greater differences were found in mean PPOS scores between VA patients and their providers (31.2 vs 41.5, respectively; p < 0.001) than university clinic patients and their providers (39.7 vs 42.6, respectively; p = 0.12).
  
  
  CONCLUSIONS
  VA patients reported preferences for a more provider-centered role than university clinic patients and there was greater mean difference in preferred role orientations between VA patients and their providers than between university clinic patients and their providers. Differences in preferred role orientations by patients and providers should be considered when designing clinical initiatives and research to improve patient care.
authors.affiliation: 1 Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP) at the Iowa City VA Medical Center, Iowa City, Iowa, USA 2 Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa, USA 3 Department of Psychology, University of Iowa College of Liberal Arts, Iowa City, Iowa, USA 4 Center for Epidemiology and Clinical Research and Section of Nephrology, Department of Medicine, Minneapolis VA Medical Center and Division of Renal Diseases and Hypertension, University of Minnesota, Minnesota, Minneapolis, USA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Kaboli
authors.forename: Austin S
authors.initials: AS
authors.lastname: Baldwin
authors.forename: Michael S
authors.initials: MS
authors.lastname: Henderson
authors.forename: Areef
authors.initials: A
authors.lastname: Ishani
authors.forename: Jamie A
authors.initials: JA
authors.lastname: Cvengros
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Christensen