Cited by 939Patient-Provider Communication in HealthcarePrimary Care and Health OutcomesEmpathy and Medical Education

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Communication Patterns of Primary Care Physicians

Roter, Debra L.·1997·JAMA: The Journal of the American Medical Association

DOI 10.1001/jama.1997.03540280088045

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Abstract

OBJECTIVES: To use audiotape analysis to describe communication patterns in primary care, to relate these to ideal relationship types as described in the literature, and to explore the patterns' relationships with physician and patient characteristics and satisfaction. DESIGN: Description of routine communication in primary care based on audiotape analysis and patient and physician exit questionnaires. SETTING: A total of 11 ambulatory clinics and private practices. PARTICIPANTS: The participants were 127 physicians and 537 patients coping with ongoing problems related to disease. MAIN OUTCOMES MEASURES: Roter Interactional Analysis System (RIAS) and patient and physician exit satisfaction questionnaires. RESULTS: Cluster analysis revealed 5 distinct communication patterns: (1) "narrowly biomedical," characterized by closed-ended medical questions and biomedical talk occurring in 32% of visits; (2) "expanded biomedical," like the restricted pattern but with moderate levels of psychosocial discussion occurring in 33% of the visits; (3) "biopsychosocial," reflecting a balance of psychosocial and biomedical topics (20% of the visits); (4) "psychosocial," characterized by psychosocial exchange (8% of visits); and (5) "consumerist," characterized primarily by patient questions and physician information giving (8% of visits). Biomedically focused visits were used more often with more sick, older, and lower income patients by younger, male physicians. Physician satisfaction was lowest in the narrowly biomedical pattern and highest in the consumerist pattern, while patient satisfaction was highest in the psychosocial pattern. CONCLUSIONS: Primary care communication patterns range from narrowly biomedical to consumerist patterns and parallel the ideal forms of patient-physician relationships described in the literature.

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Expanding Patient Involvement in Care
Greenfield, S., Kaplan, S. H., & Ware, J. E. (1985) · Annals of Internal Medicine · doi:10.7326/0003-4819-102-4-520 · Cited by 1,459
Patient-Centered Medicine: Transforming the Clinical Method
Stewart, M., Brown, J. B., Weston, W. W., McWhinney, I. R., McWilliam, C. L., & Freeman, T. R. (1995) · Cited by 1,299
Improving physicians' interviewing skills and reducing patients' emotional distress. A randomized clinical trial
ROTER, D. L. (1995) · Archives of Internal Medicine · doi:10.1001/archinte.155.17.1877 · Cited by 651
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Kaplan, S. H., Gandek, B., Greenfield, S., Rogers, W., & Ware, J. E. (1995) · Medical Care · doi:10.1097/00005650-199512000-00002 · Cited by 580
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Bridges, K. W., & Goldberg, D. P. (1985) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(85)90064-9 · Cited by 534
The relationship of physician medical interview style to patient satisfaction.
Bertakis, K. D., ROTER, D. L., & Putnam, S. M. (1991) · PubMed · Cited by 501
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Hall, J. A., Irish, J. T., Roter, D., Ehrlich, C. M., & Miller, L. H. (1994) · Health Psychology · doi:10.1037/0278-6133.13.5.384 · Cited by 427
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Stewart, M. (1984) · Social Science & Medicine · doi:10.1016/0277-9536(84)90284-3 · Cited by 403
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(1991) · Annals of Internal Medicine · doi:10.7326/0003-4819-115-6-501_2 · Cited by 309

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Accomplishing the Impossible: Talking About Body and Soul and Mind During a Medical Visit
du Pré, A. (2002) · Health Communication · doi:10.1207/s15327027hc1401_1 · Cited by 40
“Like their patients, physicians are typically more satisfied when medical conversations include a range of topics and when patients take an active role in medical conversations—in short, when talk goes beyond a strictly biomedical perspective (Lepper, Martin, & DiMatteo, 1995; Roter et al., 1997).”
BackgroundResultInfluential
O ensino-aprendizagem da relação médico-paciente: estudo de caso com esudantes do último semestre do curso de medicina
Grosseman, S., & Stoll, C. (2008) · Revista Brasileira de Educação Médica · doi:10.1590/s0100-55022008000300004 · Cited by 39
Bridging the gap: how traditional healers interact with their patients. A comparative study in Cameroon
Labhardt, N. D., Aboa, S. M., Manga, E., Bensing, J. M., & Langewitz, W. A. (2010) · Tropical Medicine & International Health · doi:10.1111/j.1365-3156.2010.02575.x · Cited by 39
“RIAS has been widely applied in high, middle- and low-income countries (Roter et al. 1997; DiPrete-Brown et al. 2000; Roter & Larson 2002; Labhardt et al. 2009).”
Method
Investigating empathy in interpreter-mediated simulated consultations: An explorative study
Krystallidou, D., Remael, A., de Boe, E., Hendrickx, K., Tsakitzidis, G., de Geuchte, S. V., & Pype, P. F. (2017) · Patient Education and Counseling · doi:10.1016/j.pec.2017.07.022 · Cited by 39
Are There Racial Differences in Patients’ Shared Decision-Making Preferences and Behaviors among Patients with Diabetes?
Peek, M. E., Tang, H., Cargill, A., & Chin, M. H. (2010) · Medical Decision Making · doi:10.1177/0272989x10384739 · Cited by 44
“Primary care physicians are also more likely to use “narrow biomedical” communication patterns (which have a restricted focus and are characterized by physician-dominant talk), in comparison to “biopyschosocial” communication patterns (characterized by more collaboration with patients and less physician verbal dominan…”
Result
Are Physician Estimates of Asthma Severity Less Accurate in Black than in White Patients?
Okelo, S. O., Wu, A. W., Merriman, B., Krishnan, J. A., & Diette, G. B. (2007) · Journal of General Internal Medicine · doi:10.1007/s11606-007-0209-1 · Cited by 39
Impact of supervision and self-assessment on doctor-patient communication in rural Mexico
Kim, Y. M. (2002) · International Journal for Quality in Health Care · doi:10.1093/intqhc/14.5.359 · Cited by 39
Does a higher frequency of difficult patient encounters lead to lower quality care?
An, P. G., Manwell, L. B., Williams, E. S., Laiteerapong, N., Brown, R., Rabatin, J. S., Schwartz, M. D., Lally, P. J., & Linzer, M. (2013) · Europe PMC (PubMed Central) · Cited by 39
A profile of communication in primary care physician telephone consultations: application of the Roter Interaction Analysis System.
Innes, M. A., Skelton, J. R., & Greenfield, S. (2006) · Europe PMC (PubMed Central) · Cited by 39
Nurse practitioner and physician communication styles
Lawson, M. T. (2002) · Applied Nursing Research · doi:10.1053/apnr.2002.29522 · Cited by 39
Patient satisfaction and ethnic identity among American Indian older adults
Garroutte, E. M., Kunovich, R. M., Jacobsen, C., & Goldberg, J. H. (2004) · Social Science & Medicine · doi:10.1016/j.socscimed.2004.03.032 · Cited by 37
“Perhaps the most striking finding in our study is the high average level of satisfaction on each dimension of care, which is comparable to those reported in related research in the general American patient population (Bertakis et al., 1991; Roter et al., 1997).”
BackgroundMethodResult
A Proactive Smoking Cessation Intervention for Socioeconomically Disadvantaged Smokers: The Role of Smoking-Related Stigma
Hammett, P. J., Fu, S. S., Nelson, D. B., Clothier, B. A., Saul, J. E., Widome, R., Danan, E. R., & Burgess, D. J. (2017) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntx085 · Cited by 38
Interpersonal Perspectives on Black–White Health Disparities: Social Policy Implications
Penner, L. A., Albrecht, T. L., Coleman, D. K., & Norton, W. E. (2007) · Social Issues and Policy Review · doi:10.1111/j.1751-2409.2007.00004.x · Cited by 40
Humor in the Physician-Patient Encounter
Berger, J. T., Coulehan, J., & Belling, C. F. (2004) · Archives of Internal Medicine · doi:10.1001/archinte.164.8.825 · Cited by 38
Outcomes assessment of on-site communication skills education in a companion animal practice
Shaw, J. R., Barley, G. E., Broadfoot, K., Hill, A. E., & ROTER, D. L. (2016) · Journal of the American Veterinary Medical Association · doi:10.2460/javma.249.4.419 · Cited by 42
Self-citation
Children in chronic pain: Promoting pediatric patients' symptom accounts in tertiary care
Clemente, I., Lee, S. H., & Heritage, J. C. (2008) · Social Science & Medicine · doi:10.1016/j.socscimed.2007.11.015 · Cited by 37
“In particular, work is needed to evaluate the extent to which clinician child-centeredness is an effective way to gather information; the different types of information that are gathered depending on the child account promotion method; the effectiveness of specific types of child account promotion vis-à-vis the child’…”
BackgroundInfluential
Perceived dominance in physicians: Are female physicians under scrutiny?
Mast, M. S., Hall, J. A., Cronauer, C. K., & Cousin, G. (2010) · Patient Education and Counseling · doi:10.1016/j.pec.2010.06.030 · Cited by 37
“It can imply asking many questions (and predominantly medical questions), interrupting frequently [5], asking closedended questions, insufficient sharing of information, using medical jargon [3], or giving orders [6].”
Background
Patients With Diabetes Speak: Exploring the Implications of Patients' Perspectives for Their Diabetes Appointments
Burke, J. A., Earley, M. A., Dixon, L., Wilke, A., & Puczynski, S. (2006) · Health Communication · doi:10.1207/s15327027hc1902_2 · Cited by 44
“Debra Roter and her associates (Hall, Roter, & Katz, 1988; Roter, 1989, 2000; Roter & Hall, 1992; Roter, Hall, & Katz, 1988; Roter et al., 1997) meta-analyzed a large number of studies of physician–patient interactions with the goal of describing the everyday business of medicine.”
BackgroundInfluential
Learning to Participate: Effect of Child Age and Parental Education on Participation in Pediatric Visits
Cox, E. D., Smith, M. A., Brown, R. L., & Fitzpatrick, M. (2009) · Health Communication · doi:10.1080/10410230902804141 · Cited by 38
“Videotapes of entire visits were coded using the Roter Interaction Analysis System, a widely used and reliable system for coding communication during the medical visit, including children’s encounters (Roter et al., 1997; van Dulmen, 1998; Wissow et al., 1998).”
Method
Recognition, reflection, and role models: Critical elements in education about care in medicine
Janssen, A. L., MacLeod, R., & Walker, S. T. (2008) · Palliative & Supportive Care · doi:10.1017/s1478951508000618 · Cited by 37
“Rather than a separate component of what it is to be a doctor, the capacity to empathize positively predicts global ratings of clinical competence among medical students (Hojat et al., 2002), as well as diagnostic accuracy and patient compliance (Roter et al., 1997; Coulehan et al., 2001).”
Background
Communication Skills and Doctor Patient Relationship
Lee, A., & Wong, S. Y. S. (2006) · Cited by 37
Physician-Patient Interaction in Reproductive Counseling
Lipkin, M. (1996) · Obstetrics and Gynecology · doi:10.1016/0029-7844(96)00247-5 · Cited by 37
Is a Shared Decision–Making Approach Effective in Improving Hypertension Management?
Deinzer, A., Veelken, R. A., Kohnen, R., & Schmieder, R. E. (2009) · Journal of Clinical Hypertension · doi:10.1111/j.1751-7176.2009.00112.x · Cited by 36
Impact of angina burden and other factors on treatment satisfaction after acute coronary syndromes
Beinart, S. C., Sales, A. E., Spertus, J. A., Plomondon, M. E., Every, N. R., & Rumsfeld, J. S. (2003) · American Heart Journal · doi:10.1016/s0002-8703(03)00256-4 · Cited by 36
Complex health care decisions with older patients in general practice: Patient-centeredness and prioritization in consultations following a geriatric assessment
Wrede, J., Voigt, I., Bleidorn, J., Hummers, E., Dierks, M., & Junius‐Walker, U. (2012) · Patient Education and Counseling · doi:10.1016/j.pec.2012.07.015 · Cited by 35
“demonstrated that patient satisfaction is highest in the psychosocial pattern, characterized by psychosocial exchange with the patients [40].”
Background
How can we provide person-centred dental care?
Apelian, N., Vergnes, J., Hovey, R. B., & Bedos, C. P. (2017) · BDJ · doi:10.1038/sj.bdj.2017.806 · Cited by 35
Quality of Care in the Social Services: Research Agenda and Methods
McMillen, J. C., Proctor, E. K., Megivern, D., Striley, C. W., Cabassa, L. J., Munson, M. R., & Dickey, B. (2005) · Social Work Research · doi:10.1093/swr/29.3.181 · Cited by 35
Impact of Scientific Versus Emotional Wording of Patient Questions on Doctor-Patient Communication in an Internet Forum: A Randomized Controlled Experiment with Medical Students
Bientzle, M., Griewatz, J., Kimmerle, J., Küppers, J., Creß, U., & Lammerding‐Koeppel, M. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.4597 · Cited by 37
“At the same time, it is occasionally recorded that personal and emotional aspects of doctor-patient relationships are largely disregarded in communication that is derived from the biomedical perspective [53].”
Patient and clinician perspectives on the outpatient after-visit summary: a qualitative study to inform improvements in visit summary design
Federman, A. D., Muñoz, A. S., Jandorf, L. H., Salmon, C., Wolf, M. S., & Kannry, J. L. (2016) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocw106 · Cited by 35
Audiologist-patient communication profiles in hearing rehabilitation appointments
Meyer, C., Barr, C., Khan, A., & Hickson, L. M. H. (2017) · Patient Education and Counseling · doi:10.1016/j.pec.2017.03.022 · Cited by 34
Is the dental profession ready for person-centred care?
Apelian, N., Vergnes, J., & Bedos, C. P. (2020) · BDJ · doi:10.1038/s41415-020-1650-3 · Cited by 34
Healthcare and Listening: A Relationship for Caring
Davis, J., Foley, A., Crigger, N., & Brannigan, M. C. (2008) · International Journal of Listening · doi:10.1080/10904010802174891 · Cited by 34
“These communication patterns are grouped into broad categories of communication process variables that include information-giving, information seeking, partnership building, social conversation, and negative talk ( Roter et al, 1997 ; Roter et al, 2002 ).”
Background

Authors: Roter, D. L.
Affiliations: Johns Hopkins University (US)
Corresponding author: Roter, Debra L.
ORCID: Roter, Debra L.
Venue: JAMA: The Journal of the American Medical Association
Publisher: American Medical Association (AMA)
Published: 1997-01-22
Volume: 277
Issue: 4
Pages: 350
ISSN: 0002-9955 (ISSN-L)
0098-7484
DOI: 10.1001/jama.1997.03540280088045
OpenAlex: W2029615977
Cited by: 939
References: 18
Citations by year: 2026: 4 · 2025: 20 · 2024: 9 · 2023: 16 · 2022: 18 · 2021: 35 · 2020: 24 · 2019: 29 · 2018: 29 · 2017: 41 · 2016: 23 · 2015: 41 · 2014: 28 · 2013: 38 · 2012: 53
FWCI: 48.64
Type: journal article
Language: en
Open access: closed
Locations: JAMA (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
Keywords: physician-patient communication, primary care, communication patterns, biomedical communication, biopsychosocial care, patient satisfaction, physician satisfaction, physician-patient relationship, outpatient care, physician characteristics, patient characteristics
MeSH terms: Analysis of Variance, Communication, Family Practice, Humans, Physician-Patient Relations, Surveys and Questionnaires, Cluster Analysis, Patient Satisfaction, Personal Autonomy, Paternalism

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Communication Patterns of Primary Care Physicians

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