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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“essential elements of the physician−patient relationship include verbal and non-verbal communication, effective questioning and transmission of information, expression of empathy and concern, partnership and participatory decision-making [4, 5].”
Background
Communiceren huisartsen volgens de verwachtingen van hun patiënten?
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“The dynamics of communication, which has been tried to measure on the basis of verbal participation questionnaires [36], as well in relation with some aspects of patient-centered communication [37], as well using the Rotter interaction analysis [38], or by studying different aspects of the biopsychosocial model in the…”
Primary care physicians’ views on the factors for enhancing patients’ trust in rural areas of Zhejiang province, China: a cross-sectional study
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“The evidence from rigorous clinical research studies show, what experts in the field consider, large beneficial effects for psychotherapy in comparison to no treatment, confirming the efficacy of psychotherapy across diverse conditions and settings.(33)(34)(35)(36)(37) There is a growing body of evidence that psychoth…”
Background
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“…focused on the general patient-physician relationship to address these disparities (Bensing and Dronkers 1992; Haskard Zolnierek and DiMatteo 2009; Roter et al. 1997; Suarez-Almazor 2004), particularly within Western medicine, where the relationship between patients and the healthcare system has…”
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Background
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Method
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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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