Differences between patient and physician perceptions of predicted compliance

One approach to improving patient compliance is for physicians to adapt their behaviour to fit patients' psychological characteristics. Previous university-based research has suggested that physician adaptation to patients' locus of control interferes with patient-physician congruence on expected compliance, but not with congruence on satisfaction with their relationship. This study was conducted in a community practice to clarify the relationship between the physician's adaptation to locus of control and likelihood of and commitment to compliance, and satisfaction with the doctor-patient match. One physician saw 148 patients with a variety of illnesses after they had completed the Health Locus of Control (HLC) questionnaire. The physician altered how he spoke with a patient based on whether the patient scored internally or externally on the HLC. After the encounter, both patient and physician rated the patient's likelihood of and commitment to complying with each of the three recommendations. The physician and each patient also rated their satisfaction with the match between them. Patients' ratings of commitment, likelihood, and satisfaction were significantly higher than those of the physician. Unlike earlier results, there were strong correlations between the patients' and physician's estimates of compliance (commitment and likelihood). Just as with the previous study, there was no correlation between the levels of physician and patient satisfaction with their match. This study indicates that physician adaptation to patients' locus of control does not interfere with compliance outcomes of doctor-patient encounters. Whether such adaptation will improve compliance outcomes is yet to be determined.