Journal of Community Health

, Volume 4, Issue 4, pp 280–290 | Cite as

Patients' percentions of physicians' behavior

Determinants of patient commitment to the therapeutic relationship
  • M. Robin DiMatteo
  • Louise M. Prince
  • Angelo Taranta
Research Reports

Abstract

This study examines the hypothesis that patients decide to remain committed to their primary care physicians (or to leave them and “doctor shop”) primarily on the basis of the “socioemotional” aspects of the physicians' behavior. It was hypothesized that physicians' demonstrations of caring for patients as people and their openness of communication would be predictive of patient commitment to the therapeutic relationship, and that the physicians' competence and role performance (including thoroughness of information gathering) as perceived by patients would be less important. Interviews were conducted with 342 inpatients and ambulatory patients in a large urban community teaching hospital after a visit with one of 38 house officers in internal medicine. Each patient was asked to (a) rate his or her physician on nine performance variables, (b) indicate his or her intention to return to that physician in the future or seek a different one, and (c) state his or her education, occupation, age, and present illness condition. The physicians' socioemotional behavior (caring and openness to communication), as well as their accessibility, tended to weight heavily in patients' decisions to continue the physician-patient relationship. In addition, the importance of some specific physician behaviors (for example, the physician's willingness to explain the medical condition) varied among subpopulations of patients.

References

  1. 1.
    Ben-Sira Z: The function of the professional's affective behavior in client satisfaction: A revised approach to social interaction theory.J Health Soc Behav 173–11, 1976.Google Scholar
  2. 2.
    Bloom SW:The Doctor and His Patient. New York, The Free Press, 1965, P 247.Google Scholar
  3. 3.
    Mechanic D:Medical Sociology: A Selective View. New York, The Free Press, 1968.Google Scholar
  4. 4.
    Ware JE, Synder MK: Dimensions of patient attitudes regarding doctors and medical care services.Med Care 13669–682, 1975.Google Scholar
  5. 5.
    Hulka BS, Zyzanski SJ, Cassel JC, et al: Scale for the measurement of attitudes toward physicians and primary medical care.Med Care 8429–436, 1970.Google Scholar
  6. 6.
    Gray PG, Cartwright A: Choosing and changing doctors.Lancet 1308–1309, 1953.Google Scholar
  7. 7.
    Kasteler J, Kane RL, Olsen DM, et al: Issues underlying prevalence of “doctor-shopping” behavior.J Health Soc Behav 17 328–339, 1976.Google Scholar
  8. 8.
    Korsch BM, Gozzi EK, Francis V: Gaps in doctor-patient communication. I Doctor-patient interaction and patient satisfaction.Pediatrics 42 855–871, 1968.Google Scholar
  9. 9.
    Doyle BJ, Ware JE: Physician conduct and other factors that affect consumer satisfaction with medical care.J Med Educ 52 793–801, 1977.Google Scholar
  10. 10.
    Vuori, H, Aaku, T, Aine E, et al: Doctor-patient relationship in the light of patient's experiences.Soc Sci Med 6 723–730, 1972.Google Scholar
  11. 11.
    Reader GG, Pratt L, Mudd MC: What patients expect from their doctors.Mod Hosp 8988–94, 1957.Google Scholar
  12. 12.
    Guilford JP:Psychometric Methods. New York, McGraw-Hill, 1954.Google Scholar
  13. 13.
    Siegel S:Nonparametric Statistics for the Behavioral Sciences. New York, McGraw-Hill, 1956. P 223.Google Scholar
  14. 14.
    Duncan OD: Socioeconomic index for occupations in the detailed classification of the Bureau of the Census, 1950 (Transformed to NORC scale). In AJ Reiss, OD Duncan, PK Hatt, et al:Occupation and Social Status. Glencoe, Ill: The Free Press, 1961. Appendix B. Pp 263–275.Google Scholar
  15. 15.
    Wyler AR, Masuda M, Holmes TH: Seriousness of illness rating scale.J Psychosom Res 11363–373, 1968.Google Scholar
  16. 16.
    Szasz TS, Hollender MH: A contribution to the philosophy of medicine: The basic models of the doctor-patient relationship.Arch Intern Med 97585–592, 1956.Google Scholar
  17. 17.
    Davis MS: Variations in patients' compliance with doctors' advice: An empirical analysis of patterns of communication.Am J Public Health 58274–288, 1968.Google Scholar
  18. 18.
    Blum RH:The Management of the Doctor-Patient Relationship. New York, McGraw-Hill, 1960.Google Scholar
  19. 19.
    Hippocrates,Volume II: On Decorum and The Physician, with English translation by EHS Jones. London, William Heinemann, 1923.Google Scholar
  20. 20.
    Shattuck FC: The science and art of medicine in some of their aspects.Boston Med Surgical J 15763–67, 1907.Google Scholar
  21. 21.
    Engel GL: The care of the patient: Art or science?Johns Hopkins Med J 140222–232, 1977.Google Scholar

Copyright information

© Human Sciences Press 1979

Authors and Affiliations

  • M. Robin DiMatteo
  • Louise M. Prince
  • Angelo Taranta

There are no affiliations available

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