The relationship of physician medical interview style to patient satisfaction.

TLDR

Previous studies linking patient satisfaction to specific interviewing behaviors have been hard to generalize because they used small, single‑site samples and acute care visits where patients and physicians had no established relationship. This collaborative study collected 550 return‑visit recordings from 127 physicians at 11 sites nationwide, analyzed with the Roter Interaction Analysis System, and paired each interview with a post‑visit satisfaction questionnaire. The analysis revealed that asking biomedical questions and patient biomedical talk, as well as physician dominance, were negatively associated with satisfaction, whereas asking and discussing psychosocial topics and counseling on psychosocial issues were positively linked, indicating that patients are most satisfied when interviews encourage psychosocial discussion in a non‑dominant atmosphere.

Abstract

The results of previous studies on the relationship between patient satisfaction and specific interviewing behaviors have been difficult to generalize because most studies have examined small samples of patients at one clinical location, and have used initial or acute care visits where the patient and physician did not have an established relationship. The present collaborative study of medical interviewing provided an opportunity to collect interviews from 550 return visits to 127 different physicians at 11 sites across the country. Tape recordings were analyzed using the Roter Interaction Analysis System, and postvisit satisfaction questionnaires were administered to patients. A number of significant relationships were found between communication during the visit and the various dimensions of patient satisfaction. Physician question asking about biomedical topics (both open- and closed-ended questions) was negatively related to patient satisfaction; however, physician question asking about psychosocial topics was positively related. Physician counseling for psychosocial issues was also positively related to patient satisfaction. Similarly, patient talk about biomedical topics was negatively related to satisfaction, while patient talk regarding psychosocial topics was positively related. Furthermore, patients were less satisfied when physicians dominated the interview by talking more or when the emotional tone was characterized by physician dominance. The findings suggest that patients are most satisfied by interviews that encourage them to talk about psychosocial issues in an atmosphere that is characterized by the absence of physician domination.