Measuring patient-centered communication in Patient–Physician consultations: Theoretical and practical issues
Abstract
The goal of patient-centered communication (PCC) is to help practitioners provide care that is concordant with the patient's values, needs and preferences, and that allows patients to provide input and participate actively in decisions regarding their health and health care. PCC is widely endorsed as a central component of high-quality health care, but it is unclear what it is and how to measure it. PCC includes four communication domains: the patient's perspective, the psychosocial context, shared understanding, and sharing power and responsibility. Problems in measuring PCC include lack of theoretical and conceptual clarity, unexamined assumptions, lack of adequate control for patient characteristics and social contexts, modest correlations between survey and observational measures, and overlap of PCC with other constructs. We outline problems in operationalizing PCC, choosing tools for assessing PCC, choosing data sources, identifying mediators of PCC, and clarifying outcomes of PCC. We propose nine areas for improvement: (1) developing theory-based operational definitions of PCC; (2) clarifying what is being measured; (3) accounting for the communication behaviors of each individual in the encounter as well as interactions among them; (4) accounting for context; (5) validating of instruments; (6) interpreting patient ratings of their physicians; (7) doing longitudinal studies; (8) examining pathways and mediators of links between PCC and outcomes; and (9) dealing with the complexity of the construct of PCC. We discuss the use of observational and survey measures, multi-method and mixed-method research, and standardized patients. The increasing influence of the PCC literature to guide medical education, licensure of clinicians, and assessments of quality provides a strong rationale for further clarification of these measurement issues.
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Motivational interviewing, originally developed to treat alcohol abuse, is a specific form of patient-centered counseling that has also been applied successfully to foster health behavior changes.
“Motivational interviewing, originally developed to treat alcohol abuse, is a specific form of patient-centered counseling that has also been applied successfully to foster health behavior changes.54–57”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [54]
Cites
Crossing the Quality Chasm: A New Health System for the 21st Century
Baker, A. (2001) · BMJ · doi:10.1136/bmj.323.7322.1192 · Cited by 10,754 · see citing works
Making Social Science Matter: Why Social Inquiry Fails and How it Can Succeed Again
Flyvbjerg, B. (2001) · doi:10.1017/cbo9780511810503 · Cited by 4,681 · see citing works
Patient-centredness: a conceptual framework and review of the empirical literature
Mead, N., & Bower, P. (2000) · Social Science & Medicine · doi:10.1016/s0277-9536(00)00098-8 · Cited by 2,993 · see citing works
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 · see citing works
Assessing the Effects of Physician-Patient Interactions on the Outcomes of Chronic Disease
Kaplan, S. H., Greenfield, S., & Ware, J. E. (1989) · Medical Care · doi:10.1097/00005650-198903001-00010 · Cited by 2,043 · see citing works
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 · see citing works
Defining and measuring patient satisfaction with medical care
Ware, J. E., Snyder, M. K., Wright, W. R., & Davies, A. R. (1983) · Evaluation and Program Planning · doi:10.1016/0149-7189(83)90005-8 · Cited by 1,259 · see citing works
Interventions for providers to promote a patient-centred approach in clinical consultations
Dwamena, F., Holmes-Rovner, M., Gaulden, C. M., Jorgenson, S., Sadigh, G., Sikorskii, A., Lewin, S., Smith, R. C., Coffey, J., Olomu, A., et al. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003267.pub2 · Cited by 1,227 · see citing works
Fiscella, K. A., Franks, P. J., Gold, M. R., & Clancy, C. M. (2000) · JAMA · doi:10.1001/jama.283.19.2579 · Cited by 1,186 · see citing works
Self-citationSupporting Autonomy to Motivate Patients With Diabetes for Glucose Control
Williams, G. C., Freedman, Z. R., & Deci, E. L. (1998) · Diabetes Care · doi:10.2337/diacare.21.10.1644 · Cited by 1,129 · see citing works
Patients’ participation in medical care
Greenfield, S., Kaplan, S. H., Ware, J. E., Yano, E. M., & Frank, H. J. L. (1988) · Journal of General Internal Medicine · doi:10.1007/bf02595921 · Cited by 1,117 · see citing works
Towards a global definition of patient centred care
Stewart, M. (2001) · BMJ · doi:10.1136/bmj.322.7284.444 · Cited by 1,114 · see citing works
Epstein, R. M. (1999) · JAMA · doi:10.1001/jama.282.9.833 · Cited by 1,036 · see citing works
Self-citationPatient Race/Ethnicity and Quality of Patient–Physician Communication During Medical Visits
Johnson, R. L., Roter, D., Powe, N. R., & Cooper, L. A. (2004) · American Journal of Public Health · doi:10.2105/ajph.94.12.2084 · Cited by 955 · see citing works
Communication Patterns of Primary Care Physicians
Roter, D. L. (1997) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1997.03540280088045 · Cited by 939 · cited 1× · see citing works
“However, few instruments measure contributions of relationships, health systems and patients to PCC. PCC is both a trait (an overall style of practice, McWhinney, 1995) and a state (behaviors during a particular interaction, Roter et al., 1997).”
BackgroundGaps in doctor-patient communication. 1. Doctor-patient interaction and patient satisfaction.
KORSCH, B. M., Gozzi, E. K., & Francis, V. (1968) · PubMed · Cited by 925 · see citing works
ROTER, D. L., & Larson, S. (2002) · Patient Education and Counseling · doi:10.1016/s0738-3991(02)00012-5 · Cited by 913 · see citing works
Little, P. S., Everitt, H., Williamson, I. G., Warner, G. T., Moore, M. V., Gould, C., Ferrier, K., & Payne, S. A. (2001) · BMJ · doi:10.1136/bmj.323.7318.908 · Cited by 892 · see citing works
GAPS IN DOCTOR-PATIENT COMMUNICATION
KORSCH, B. M., Gozzi, E. K., & Francis, V. (1968) · PEDIATRICS · doi:10.1542/peds.42.5.855 · Cited by 753 · see citing works
Soliciting the patient's agenda: have we improved?
Marvel, M. K., Epstein, R. M., Flowers, K., & Beckman, H. (1999) · PubMed · doi:10.1001/jama.281.3.283 · Cited by 735 · see citing works
Self-citationThe Primary Care Assessment Survey
Safran, D. G., Kosinski, M. R., Tarlov, A. R., Rogers, W. H., Taira, D. A., Lieberman, N., & Ware, J. E. (1998) · Medical Care · doi:10.1097/00005650-199805000-00012 · Cited by 690 · see citing works
Doctors' stories: the narrative structure of medical knowledge
Loudon, M. (1991) · Choice Reviews Online · doi:10.5860/choice.29-2135 · Cited by 673 · see citing works
Assessing Competence in Communication and Interpersonal Skills: The Kalamazoo II Report
Duffy, F. D., Gordon, G. H., Whelan, G. P., Cole‐Kelly, K., & Frankel, R. M. (2004) · Academic Medicine · doi:10.1097/00001888-200406000-00002 · Cited by 664 · see citing works
Interacting with cancer patients: the significance of physicians' communication behavior
Arora, N. K. (2003) · Social Science & Medicine · doi:10.1016/s0277-9536(02)00449-5 · Cited by 661 · see citing works
Autonomous regulation and long-term medication adherence in adult outpatients.
Williams, G. C., Rodin, G. C., Ryan, R. M., Grolnick, W. S., & Deci, E. L. (1998) · Health Psychology · doi:10.1037//0278-6133.17.3.269 · Cited by 642 · see citing works
ROTER, D. L. (1977) · Health Education Monographs · doi:10.1177/109019817700500402 · Cited by 639 · see citing works
Patient-centred consultations and outcomes in primary care: a review of the literature
Mead, N., & Bower, P. (2002) · Patient Education and Counseling · doi:10.1016/s0738-3991(02)00099-x · Cited by 613 · see citing works
Time and the Patient–Physician Relationship
Dugdale, D. C., Epstein, R., & Pantilat, S. Z. (1999) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.1999.00263.x · Cited by 609 · see citing works
Self-citationROTER, D. L. (1995) · Archives of Internal Medicine · doi:10.1001/archinte.155.17.1877 · Cited by 581 · see citing works
Griffin, S. J. (2004) · The Annals of Family Medicine · doi:10.1370/afm.142 · Cited by 578 · see citing works
Interventions for providers to promote a patient-centred approach in clinical consultations
Lewin, S., Skea, Z., Entwistle, V. A., Zwarenstein, M., & Dick, J. (2001) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003267 · Cited by 530 · see citing works
Autonomous regulation and long-term medication adherence in adult outpatients.
Williams, G. C., Rodin, G. C., Ryan, R. M., et al. (1998) · Health Psychology · doi:10.1037/0278-6133.17.3.269 · Cited by 494 · see citing works
Kinmonth, A. L., Woodcock, A., Griffin, S., Spiegal, N., & Campbell, M. J. (1998) · BMJ · doi:10.1136/bmj.317.7167.1202 · Cited by 474 · see citing works
Patient-centredness in chronic illness: what is it and does it matter?
Michie, S. G., Miles, J., & Weinman, J. A. (2003) · Patient Education and Counseling · doi:10.1016/s0738-3991(02)00194-5 · Cited by 471 · see citing works
Patient-centred medicine: Transforming the clinical method
Brown, J. B. (1998) · Patient Education and Counseling · doi:10.1016/s0738-3991(98)90096-9 · Cited by 456 · see citing works
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 · see citing works
Doctor-patient interactions in oncology
Ford, S., Fallowfield, L. J., & Lewis, S. W. (1996) · Social Science & Medicine · doi:10.1016/0277-9536(95)00265-0 · Cited by 390 · see citing works
Patients’ perceived involvement in care scale:
Lerman, C. E., Brody, D. S., Caputo, G. C., Smith, D. G., Lazaro, C. G., & Wolfson, H. G. (1990) · Journal of General Internal Medicine · doi:10.1007/bf02602306 · Cited by 389 · see citing works
Patient-Centered Communication and Diagnostic Testing
Epstein, R. M. (2005) · The Annals of Family Medicine · doi:10.1370/afm.348 · Cited by 373 · see citing works
Self-citationUse of Peer Ratings to Evaluate Physician Performance
Ramsey, P. G. (1993) · JAMA · doi:10.1001/jama.1993.03500130069034 · Cited by 352 · see citing works
Complications: A Surgeon's Notes on an Imperfect Science
Gawande, A. A. (2002) · DigitalGeorgetown (Georgetown University Library) · doi:10.1136/jramc-153-03-20 · Cited by 326 · see citing works
Doctors' communication of trust, care, and respect in breast cancer: qualitative study
Burkitt‐Wright, E., Holcombe, C., & Salmon, P. (2004) · BMJ · doi:10.1136/bmj.38046.771308.7c · Cited by 288 · see citing works
Mead, N., Bower, P., & Hann, M. (2002) · Social Science & Medicine · doi:10.1016/s0277-9536(01)00171-x · Cited by 275 · see citing works
Switching doctors: predictors of voluntary disenrollment from a primary physician's practice.
Safran, D. G., Montgomery, J. E., Chang, H., Murphy, J., & Rogers, W. H. (2001) · PubMed · Cited by 274 · see citing works
Krupat, E., Bell, R. A., Kravitz, R. L., Thom, D. H., & Azari, R. S. (2001) · PubMed · Cited by 270 · see citing works
Self-citationPatient-physician communication assessment instruments:
Boon, H. S., & Stewart, M. (1998) · Patient Education and Counseling · doi:10.1016/s0738-3991(98)00063-9 · Cited by 246 · see citing works
Understanding change in primary care practice using complexity theory.
Miller, W. L., Crabtree, B. F., McDaniel, R., & Stange, K. C. (1998) · PubMed · Cited by 233 · see citing works
Flocke, S. A., Miller, W. L., & Crabtree, B. F. (2002) · PubMed · Cited by 230 · see citing works
Beliefs about control in the physician-patient relationship
Street, R. L., Krupat, E., Bell, R. A., Kravitz, R. L., & Haidet, P. (2003) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2003.20749.x · Cited by 229 · see citing works
Self-citationMeasuring patient-centredness: a comparison of three observation-based instruments
Mead, N., & Bower, P. (2000) · Patient Education and Counseling · doi:10.1016/s0738-3991(99)00092-0 · Cited by 222 · see citing works
Problems and Prospects for Health Services Research on Provider-Patient Communication
Inui, T. S., & Carter, W. B. (1985) · Medical Care · doi:10.1097/00005650-198505000-00013 · Cited by 209 · see citing works
Protheroe, J. (2001) · Western Journal of Medicine · doi:10.1136/ewjm.174.5.311 · Cited by 201 · see citing works
Individualized Patient Education and Coaching to Improve Pain Control Among Cancer Outpatients
Oliver, J. W., Kravitz, R. L., Kaplan, S. H., & Meyers, F. J. (2001) · Journal of Clinical Oncology · doi:10.1200/jco.2001.19.8.2206 · Cited by 200 · see citing works
Self-citationThe Association of Attributes of Primary Care With the Delivery of Clinical Preventive Services
Flocke, S. A., Stange, K. C., & Zyzanski, S. J. (1998) · Medical Care · doi:10.1097/00005650-199808001-00004 · Cited by 169 · see citing works
Using video-recorded consultations for research in primary care: advantages and limitations
Coleman, T. (2000) · Family Practice · doi:10.1093/fampra/17.5.422 · Cited by 169 · see citing works
The General Practice Assessment Survey (GPAS): tests of data quality and measurement properties
Ramsay, J. (2000) · Family Practice · doi:10.1093/fampra/17.5.372 · Cited by 168 · see citing works
Doctors' Stories: The Narrative Structure of Medical Knowledge
Miles, S. H. (1991) · JAMA · doi:10.1001/jama.1991.03470090109047 · Cited by 161 · see citing works
Awkward Moments in Patient-Physician Communication about HIV Risk
Epstein, R. M., Morse, D. S., Frankel, R. M., Frarey, L., Anderson, K., & Beckman, H. B. (1998) · Annals of Internal Medicine · doi:10.7326/0003-4819-128-6-199803150-00003 · Cited by 157 · see citing works
Self-citationHowie, J. G. (2004) · Family Practice · doi:10.1093/fampra/cmh419 · Cited by 148 · see citing works
Preliminary Evidence of Impaired Thinking in Sick Patients
Cassell, E. J., Leon, A. C., & Kaufman, S. G. (2001) · Annals of Internal Medicine · doi:10.7326/0003-4819-134-12-200106190-00012 · Cited by 141 · see citing works
Hall, J. A., Roter, D., Milburn, M. A., & Daltroy, L. (1996) · Medical Care · doi:10.1097/00005650-199612000-00006 · Cited by 141 · see citing works
Using Standardized Patients to Measure Quality: Evidence from the Literature and a Prospective Study
Glassman, P. A., Luck, J., O’Gara, E. M., et al. (2000) · The Joint Commission Journal on Quality Improvement · doi:10.1016/s1070-3241(00)26055-0 · Cited by 133 · see citing works
Communication in primary care: The role of patient and practitioner explanatory models
Helman, C. G. (1985) · Social Science & Medicine · doi:10.1016/0277-9536(85)90348-x · Cited by 130 · see citing works
Does physician uncertainty affect patient satisfaction?
Johnson, C. G., Levenkron, J. C., Suchman, A. L., & Manchester, R. A. (1988) · Journal of General Internal Medicine · doi:10.1007/bf02596120 · Cited by 126 · see citing works
Complications: A Surgeon's Notes on an Imperfect Science
Crowell, R. M. (2002) · JAMA · doi:10.1001/jama.288.14.1781-a · Cited by 124 · see citing works
Quantitative and qualitative approaches to the evaluation of the medical dialogue
ROTER, D. L., & Frankel, R. M. (1992) · Social Science & Medicine · doi:10.1016/0277-9536(92)90283-v · Cited by 117 · see citing works
Galassi, J., Schanberg, R., & Ware, W. (1992) · Psychological Assessment · doi:10.1037/1040-3590.4.3.346 · Cited by 116 · see citing works
Williams, G. C., McGregor, H. A., Zeldman, A., Freedman, Z. R., Deci, E. L., & Elder, D. (2004) · Patient Education and Counseling · doi:10.1016/j.pec.2003.11.008 · Cited by 114 · see citing works
Epstein, R. M. (2003) · Families Systems & Health · doi:10.1037/h0089494 · Cited by 113 · see citing works
Self-citationDevelopment and validation of the Davis Observation Code.
Callahan, E. J., & Bertakis, K. D. (1991) · PubMed · Cited by 102 · see citing works
The other half of the whole: teaching patients to communicate with physicians.
Post, D. M., Cegala, D. J., & Miser, W. F. (2002) · PubMed · Cited by 100 · see citing works
The Headache Study Group of The University of Western Ontario (1986) · Headache The Journal of Head and Face Pain · doi:10.1111/j.1526-4610.1986.hed2606285.x · Cited by 100 · see citing works
Patient centredness in the MRCGP video examination: analysis of large cohort
Campion, P., Foulkes, J., Neighbour, R., et al. (2002) · BMJ · doi:10.1136/bmj.325.7366.691 · Cited by 92 · see citing works
Facilitation of Patient Involvement in Care: Development and Validation of a Scale
Martin, L. R., Matteo, M. R. D., & Lepper, H. S. (2001) · Behavioral Medicine · doi:10.1080/08964280109595777 · Cited by 89 · see citing works
Why we need a new clinical method
McWhinney, I. R. (1993) · Scandinavian Journal of Primary Health Care · doi:10.3109/02813439308994894 · Cited by 87 · see citing works
Analyzing medical dialogues: strength and weakness of Roter’s interaction analysis system (RIAS)
Sandvik, M., Eide, H., Lind, M., Graugaard, P. K., Torper, J., & Finset, A. (2002) · Patient Education and Counseling · doi:10.1016/s0738-3991(02)00014-9 · Cited by 85 · see citing works
Use of peer ratings to evaluate physician performance
Ramsey, P. G. (1993) · JAMA · doi:10.1001/jama.269.13.1655 · Cited by 85 · see citing works
Bell, R. A., Kravitz, R. L., Thom, D. H., Krupat, E., & Azari, R. S. (2001) · Archives of Internal Medicine · doi:10.1001/archinte.161.16.1977 · Cited by 84 · see citing works
Self-citationFitzgerald, F. (1999) · Annals of Internal Medicine · doi:10.7326/0003-4819-130-1-199901050-00015 · Cited by 84 · see citing works
An objective structured clinical examination for the licentiate of the Medical Council of Canada
Reznick, R. K., Blackmore, D. E., Cohen, R., Baumber, J. S., Rothman, A., Smee, S. N., Chalmers, A., Poldre, P. A., Birtwhistte, R., & Walsh, P. (1993) · Academic Medicine · doi:10.1097/00001888-199310000-00028 · Cited by 75 · see citing works
Ogden, J., Ambrose, L., Khadra, A., Manthri, S., Symons, L., Vass, A., & Williams, M. (2002) · Patient Education and Counseling · doi:10.1016/s0738-3991(01)00200-2 · Cited by 65 · see citing works
Martin, L. R., Jahng, K. H., Golin, C. E., & DiMatteo, M. R. (2003) · Behavioral Medicine · doi:10.1080/08964280309596054 · Cited by 61 · see citing works
Are Patients' Ratings of Their Physicians Related to Health Outcomes?
Franks, P. W. (2005) · The Annals of Family Medicine · doi:10.1370/afm.267 · Cited by 58 · see citing works
Self-citationLongitudinal Care Improves Disclosure of Psychosocial Information
Wissow, L. S. (2003) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.157.5.419 · Cited by 54 · see citing works
Campbell, M. K., Silver, R. W., Hoch, J. S., et al. (2005) · PubMed · Cited by 49 · see citing works
Use of standardized patients in the assessment of medical practice.
Tamblyn, R. M. (1998) · PubMed · Cited by 46 · see citing works
Recognizing and managing depression in primary care: a standardized patient study.
Carney, P. A., Dietrich, A. J., Eliassen, M. S., et al. (1999) · PubMed · Cited by 44 · see citing works
Reactions of patients to video recording of consultations in general practice.
Herzmark, G. A. (1985) · BMJ · doi:10.1136/bmj.291.6491.315 · Cited by 37 · see citing works
Arborelius, E., & Timpka, T. (1990) · Family Practice · doi:10.1093/fampra/7.2.84 · Cited by 36 · see citing works
First-visit bias in the measurement of clinical competence with standardized patients
Tamblyn, R. M., Abrahamowicz, M., Berkson, L., Dauphinée, W. D., Gayton, D., Grad, R. M., Isaac, L. M., Marrache, M., McLeod, P. J., & Snell, L. S. (1992) · Academic Medicine · doi:10.1097/00001888-199210000-00027 · Cited by 36 · see citing works
A comparison of initial and established patient encounters using the Davis Observation Code.
Bertakis, K. D., & Callahan, E. J. (1992) · PubMed · Cited by 34 · see citing works
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Epstein, R. M., & Street, R. L. (2011) · The Annals of Family Medicine · doi:10.1370/afm.1239 · Cited by 1,956 · see citing works
Self-citationAssessment in medical education
Epstein, R. M. (2007) · New England Journal of Medicine · doi:10.1056/nejmra054784 · Cited by 1,872 · see citing works
Self-citationPatient-centered care and adherence: definitions and applications to improve outcomes
Robinson, J. H., Callister, L. C., Berry, J. A., & Dearing, K. A. (2008) · Journal of the American Academy of Nurse Practitioners · doi:10.1111/j.1745-7599.2008.00360.x · Cited by 721 · see citing works
Defining and Measuring the Patient-Centered Medical Home
Stange, K. C., Nutting, P. A., Miller, W. L., Jaén, C. R., Crabtree, B. F., Flocke, S. A., & Gill, J. M. (2010) · Journal of General Internal Medicine · doi:10.1007/s11606-010-1291-3 · Cited by 516 · see citing works
Chapman, B. P., Roberts, B., & Duberstein, P. (2011) · Journal of Aging Research · doi:10.4061/2011/759170 · Cited by 283 · see citing works
Self-citationHesselink, G., Flink, M., Olsson, M., Barach, P., Dudzik-Urbaniak, E., Orrego, C., Toccafondi, G., Kalkman, C., Johnson, J. K., Schoonhoven, L., et al. (2012) · BMJ Quality & Safety · doi:10.1136/bmjqs-2012-001165 · Cited by 203 · see citing works
Social networks – the future for health care delivery
Griffiths, F., Cave, J., Boardman, F., Ren, J., Pawlikowska, T., Ball, R., Clarke, A., & Cohen, A. (2012) · Social Science & Medicine · doi:10.1016/j.socscimed.2012.08.023 · Cited by 196 · see citing works
Sommerhalder, K., Abraham, A., Zufferey, M. C., Barth, J., & Abel, T. (2009) · Patient Education and Counseling · doi:10.1016/j.pec.2009.03.028 · Cited by 200 · see citing works
Better Population Health Through Behavior Change in Adults: A Call to Action
Spring, B., Ockene, J. K., Gidding, S. S., Mozaffarian, D., Moore, S., Rosal, M. C., Brown, M. D., Vafiadis, D. K., Cohen, D. L., Burke, L. E., et al. (2013) · Circulation · doi:10.1161/01.cir.0000435173.25936.e1 · Cited by 195 · see citing works
Jay, M., Gillespie, C., Schlair, S., Sherman, S., & Kalet, A. (2010) · BMC Health Services Research · doi:10.1186/1472-6963-10-159 · Cited by 158 · see citing works
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Epstein, R. M., Shields, C. G., Meldrum, S. C., Fiscella, K., Carroll, J., Carney, P. A., & Duberstein, P. R. (2006) · Psychosomatic Medicine · doi:10.1097/01.psy.0000204652.27246.5b · Cited by 136 · see citing works
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McDaniel, S. H. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.12.1321 · Cited by 113 · see citing works
Hintz, E. A. (2023) · Health Communication · doi:10.1080/10410236.2022.2081046 · Cited by 106 · see citing works
Afshar, Y., Mei, J. Y., Gregory, K. D., Kilpatrick, S. J., & Esakoff, T. F. (2018) · Birth · doi:10.1111/birt.12320 · Cited by 64 · see citing works
Personality and Perceived Health in Older Adults: The Five Factor Model in Primary Care
Chapman, B. P., Duberstein, P. R., Sörensen, S., & Lyness, J. M. (2006) · The Journals of Gerontology: Series B · doi:10.1093/geronb/61.6.p362 · Cited by 58 · see citing works
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Wolff, J. L., & Roter, D. L. (2012) · Journal of General Internal Medicine · doi:10.1007/s11606-011-1957-5 · Cited by 53 · see citing works
Jensen, C. G., Elsass, P., Neustrup, L., Bihal, T., Flyger, H., Kay, S. M., Khan, S., Jensen, S. S., Pedersen, A., & Würtzen, H. (2014) · Patient Education and Counseling · doi:10.1016/j.pec.2014.07.020 · Cited by 18 · see citing works
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Liddy, C., Hauteclocque, J., Moroz, I., Oppenheimer, L., Sturge, D., Burns, K. K., Horsley, T., Tuot, D., & Keely, E. (2022) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x20926779 · Cited by 6 · see citing works
- Authors
- Epstein, R. M., Franks, P., Fiscella, K., Shields, C. G., Meldrum, S. C., Kravitz, R. L., & Duberstein, P. R.
- Affiliations
- University of Rochester Medicine (US)
- University of California, Davis (US)
- Corresponding author
- Epstein, Ronald M.
- ORCID
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 2005-10
- Volume
- 61
- Issue
- 7
- Pages
- 1516-1528
- ISSN
- 0277-9536 (ISSN-L)
- OpenAlex
- W1990480169
- Cited by
- 1,211
- References
- 92
- Citations by year
- 2026: 39 · 2025: 47 · 2024: 49 · 2023: 59 · 2022: 65 · 2021: 71 · 2020: 87 · 2019: 72 · 2018: 65 · 2017: 117 · 2016: 63 · 2015: 65 · 2014: 77 · 2013: 75 · 2012: 53
- FWCI
- 41.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Social Science & Medicine (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- Agency for Healthcare Research and Quality (R01-HS1610-01A1)
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Keywords
- patient-centered communication, patient-physician communication, operational definitions, shared decision-making, patient satisfaction survey, observational measures, standardized patients, psychosocial environment, mutual understanding, patient participation in care, quality of care evaluation, medical education
- MeSH terms
- Communication, Data Collection, Humans, Models, Theoretical, Physician-Patient Relations, Quality Assurance, Health Care, Quality of Health Care, Referral and Consultation, United States, Patient-Centered Care
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