Journal of General Internal Medicine

, Volume 11, Issue 3, pp 147–155 | Cite as

Effects of a physician communication intervention on patient care outcomes

  • Sandra K. Joos
  • David H. Hickam
  • Geoffrey H. Gordon
  • Laurence H. Baker
Original Articles

Abstract

OBJECTIVE: To determine whether an intervention designed to improve patient-physician communication increases the frequency with which physicians elicit patients’ concerns, changes other communication behaviors, and improves health care outcomes.

DESIGN: Pretest-posttest design with random assignment of physicians to intervention or control groups.

SETTING: General medicine clinics of a university-affiliated Veterans Affairs Hospital.

PATZEWTS/PARTICIPANTS: Forty-two physicians and 348 continuity care patients taking prescription medications for chronic medical conditions.

INTERVENTIONS: Intervention group physicians received 4.5 hours of training on eliciting and responding to patients’ concerns and requests, and their patients filled out the Patient Requests for Services Questionnaire prior to a subsequent clinic visit. Control group physicians received 4.5 hours of training in medical decision-making.

MEASUREMENTS AND MAIN RESULTS: The frequency with which physicians elicited all of a patient’s concerns increased in the intervention group as compared with the control group (p=.032). Patients perceptions of the amount of information received from the physician did increase significantly (p<.05), but the actual magnitude of change was small. A measure of patient satisfaction with the physicians was high at baseline and also showed no significant change after the intervention. Likewise, the intervention was not associated with changes in patient compliance with medications or appointments, nor were there any effects on outpatient utilization.

CONCLUSIONS: A low-intensity intervention changed physician behavior but had no effect on patient outcomes such as satisfaction, compliance, or utilization. Interventions may need to focus on physicians and patients to have the greatest effect.

Key words

doctor-patient communication patient satisfaction ambulatory care 

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Copyright information

© Blackwell Science, Inc. 1996

Authors and Affiliations

  • Sandra K. Joos
    • 1
    • 4
  • David H. Hickam
    • 1
    • 2
    • 4
  • Geoffrey H. Gordon
    • 2
    • 4
  • Laurence H. Baker
    • 3
    • 5
  1. 1.the Health Services Research and Development ProgramPortland Veterans Affairs Medical CenterUSA
  2. 2.Medical ServicePortland Veterans Affairs Medical CenterUSA
  3. 3.Psychology ServicePortland Veterans Affairs Medical CenterUSA
  4. 4.Department of MedicineOregon Health Sciences UniversityUSA
  5. 5.Department of Medical PsychologyOregon Health Sciences UniversityUSA

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