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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Opportunities to Increase Science of Diversity and Inclusion in Clinical Trials: Equity and a Lack of a Control
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“41,42 43–45 By constructing for physician’s situation-specific plans for discussing a trial with a patient, interventions hope to increase the likelihood that physician participants will engage in said behavior, and by layering skills, the interventions build upon one another to establish a solid…”
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“Doctors can create a better impression on the patient by managing the patient’s expectations of communication (Roter et al., 1997) and by including social talk in the interaction (Deveugele, Derese, & De Maeseneer, 2002).”
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“In physical health, research indicates that patients often do not share questions and concerns with their providers, do not ask for information, and may be reluctant to voice their opinions because of pressure to conform to ‘‘traditional’’ patient roles or fear of being labeled ‘‘difficult’’ (Beisecker and Beisecker 1…”
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“Literature provides several conceptual frameworks to clarify and define the construct of physician–patient communication skills (Brunett et al., 2001; de Haes & Bensing, 2009; Duffy et al., 2004; Hoppe et al., 2013; Roter et al., 1997; Sawa, 1986; Schirmer et al., 2005).”
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“These results are consistent with Roter and Johnson’s research, which revealed that doctors engaged in less psychosocial talk and more biomedical information-giving during interethnic consultations [22,23].”
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“Specifically, more information is exchanged in a visits to female physicians (Frank & Harvey, 1996; Hall & Roter, 1998; Roter, Lipkin, & Korsgaard, 1991; Roter, Stewart, Putnam, Lipkin, Stiles, & Inui, 1997 ), women who see female physi cians report receiving more preventive clinical screen ing and counseling care (…”
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“Many discussions of the use of electronic systems in the literature remain narrow in that their emphasis is on data collection methods that follow a biomedical interview format that is known to reduce satisfaction of both providers and patients [12].”
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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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