The DOI matches its Crossref record; 18 of the 18 references it cites were found in a registry or an index.
Communication Patterns of Primary Care Physicians
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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“Patients approached in the narrowly biomedical pattern (characterised by low amount of talk about psychosocial issues, high percentage of biomedical talk and a high percentage of question asking by the physician; low patient communication control; physician directed, guided) were more likely to be poorer (p<0.02)than patients approached in other patterns.(35)”
From Socio-economic status of the patient and doctor–patient communication: does it make a difference? (2005) · cites this paper as [35]
In the citing paper
“Studies of patient-centered care suggest significant benefits in terms of patient satisfaction and medical outcomes.110–114”
From Reducing Racial Bias Among Health Care Providers: Lessons from Social-Cognitive Psychology (2007) · cites this paper as [113]
Citations
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Self-citationWhat is a successful doctor-patient interview? a study of interactions and outcomes
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Cited by
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The impact of patient-centered care on outcomes.
Stewart, M., Brown, J. B., DONNER, A. P., McWhinney, I. R., Oates, J., Weston, W. W., & Jordan, J. (2000) · PubMed · Cited by 2,508
Physician Communication and Patient Adherence to Treatment
Haskard‐Zolnierek, K. B., & DiMatteo, M. R. (2009) · Medical Care · doi:10.1097/mlr.0b013e31819a5acc · Cited by 2,522
Race, Gender, and Partnership in the Patient-Physician Relationship
Cooper, L. A. (1999) · JAMA · doi:10.1001/jama.282.6.583 · Cited by 2,161
“Recent studies of patient-physician communication in primary care show the highest levels of patient satisfaction and the lowest level of malpractice claims with the psychosocial pattern, which is characterized by psychosocial exchange and an almost equal distribution of patient and physician talk.(41-43) Our study qu…”
BackgroundEmpathy Decline and Its Reasons: A Systematic Review of Studies With Medical Students and Residents
Neumann, M., Edelhäuser, F., Tauschel, D., Fischer, M. R., Wirtz, M. A., Woopen, C., Haramati, A., & Scheffer, C. (2011) · Academic Medicine · doi:10.1097/acm.0b013e318221e615 · Cited by 1,708
Levinson, W. S. (1997) · JAMA · doi:10.1001/jama.277.7.553 · Cited by 1,794
Metadata
- 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
- 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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