Patient-physician role relationships and patient activation among individuals with chronic illness
Open accessAbstract
Objective: To examine whether chronically ill patients’ perceptions of their role relationships with their physicians are associated with levels of patient activation. Data Sources: Random digit dial survey of 8,140 chronically ill patients and the A rea R esource F ile. Study Design: Cross‐sectional, multivariate analysis of the relationship between dimensions of patient–physician role relationships and level of patient activation. The study controlled for variables related to patient demographics, socioeconomic status, health status, and market and family context. Principal Findings: Higher perceived quality of interpersonal exchange with physicians, greater fairness in the treatment process, and more out‐of‐office contact with physicians were associated with higher levels of patient activation. Treatment goal setting was not significantly associated with patient activation. Conclusion: Patient–physician relationships are an important factor in patients taking a more active role in their health and health care. Efforts to increase activation that focus only on individual patients ignore the important fact that the nature of roles and relationships between provider and patient can shape the behaviors and attitudes of patients in ways that support or discourage patient activation.
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Strong patient-provider relationships have long been acknowledged as crucial for delivering high-quality, person-centred care.
“Strong patient-provider relationships have long been acknowledged as crucial for delivering high-quality, person-centred care [40–43].”
From Caregiver experiences of an integrative patient-centered digital health application for pediatric type 1 diabetes care: Findings from a pilot clinical trial (2025) · cites this paper as [43]
The Discussion says that high-quality patient–physician exchanges involve rapport, trust, and partnership, and that changing the relationship may provide an important foundation for improving health care quality. This supports the broad link, but the paper's tentative “may” does not establish that strong relationships are crucial to delivering person-centred care generally. (LLM, conf=0.84)
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“Strong patient-provider relationships have long been acknowledged as crucial for delivering high-quality, person-centred care [40–43].”
- Authors
- Alexander, J. A., Hearld, L. R., Mittler, J. N., & Harvey, J.
- Affiliations
- University of Michigan (US)
- University of Alabama at Birmingham (US)
- Pennsylvania State University (US)
- Corresponding author
- Alexander, Jeffrey A.
- Venue
- Health Services Research
- Publisher
- Wiley
- Published
- 2011-11-18
- Volume
- 47
- Issue
- 3pt1
- Pages
- 1201-1223
- ISSN
- 0017-9124 (ISSN-L)
- 1475-6773
- PMC
- PMC3423181
- OpenAlex
- W2062285213
- Cited by
- 206
- References
- 34
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 10 · 2023: 18 · 2022: 16 · 2021: 15 · 2020: 16 · 2019: 12 · 2018: 18 · 2017: 23 · 2016: 19 · 2015: 21 · 2014: 11 · 2013: 9 · 2012: 3
- FWCI
- 13.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Health Services Research (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Funders
- Robert Wood Johnson Foundation
- School of Public Health, University of Michigan
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
- Keywords
- patient activation, physician-patient relationship, chronic disease, treatment goal setting
- MeSH terms
- Chronic Disease, Cross-Sectional Studies, Female, Health Status, Humans, Male, Middle Aged, Patient Participation, Physician-Patient Relations, Socioeconomic Factors, United States, Multivariate Analysis, Least-Squares Analysis, Patient Satisfaction
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