title: Do physician communication skills influence screening mammography utilization?
abstract: BACKGROUND
  The quality of physician communication skills influences health-related decisions, including use of cancer screening tests. We assessed whether patient-physician communication examination scores in a national, standardized clinical skills examination predicted future use of screening mammography (SM).
  
  
  METHODS
  Cohort study of 413 physicians taking the Medical Council of Canada clinical skills examination between 1993 and 1996, with follow up until 2006. Administrative claims for SM performed within 12 months of a comprehensive health maintenance visit for women 50-69 years old were reviewed. Multivariable regression was used to estimate the relationship between physician communication skills exam score and patients' SM use while controlling for other factors.
  
  
  RESULTS
  Overall, 33.8 % of 96,708 eligible women who visited study physicians between 1993 and 2006 had an SM in the 12 months following an index visit. Patient-related factors associated with increased SM use included higher income, non-urban residence, low Charlson co-morbidity index, prior benign breast biopsy and an interval >12 months since the previous mammogram. Physician-related factors associated with increased use of SM included female sex, surgical specialty, and higher communication skills score. After adjusting for physician and patient-related factors, the odds of SM increased by 24 % for 2SD increase in communication score (OR: 1.24, 95 % CI: 1.11 - 1.38). This impact was even greater in urban areas (OR 1.30, 95 % CI: 1.16, 1.46) and did not vary with practice experience (interaction p-value 0.74).
  
  
  CONCLUSIONS
  Physicians with better communication skills documented by a standardized licensing examination were more successful at obtaining SM for their patients.
authors: Clinical and Health Informatics Research Group, McGill University, 1140 Pine Avenue West, Montreal, QC, H3A 1A3, Canada. ari.meguerditchian@mcgill.ca
authors: Ari-Nareg
authors: AN
authors: Meguerditchian
authors: Dale
authors: D
authors: Dauphinee
authors: Nadyne
authors: N
authors: Girard
authors: Tewodros
authors: T
authors: Eguale
authors: Kristen
authors: K
authors: Riedel
authors: André
authors: A
authors: Jacques
authors: Sarkis
authors: S
authors: Meterissian
authors: David L
authors: DL
authors: Buckeridge
authors: Michal
authors: M
authors: Abrahamowicz
authors: Robyn
authors: R
authors: Tamblyn
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D002983:Clinical Competence / Q000706:statistics & numerical data; D015331:Cohort Studies; D003142:Communication; D015897:Comorbidity; D004521:Educational Measurement; D018588:Fee-for-Service Plans / Q000191:economics; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008327:Mammography / Q000523:psychology / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000523:psychology / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011792:Quebec; D017678:Sex Distribution; D013038:Specialization; D019472:Universal Health Insurance / Q000706:statistics & numerical data