Patient-centered communication: do patients really prefer it?

To investigate patient preferences for a patient-centered or a biomedical communication style.

Randomized study.

Urgent care and ambulatory medicine clinics in an academic medical center.

We recruited 250 English-speaking adult patients, excluding patients whose medical illnesses prevented evaluation of the study intervention.

Participants watched one of three videotaped scenarios of simulated patient-physician discussions of complementary and alternative medicine (CAM). Each participant watched two versions of the scenario (biomedical vs. patient-centered communication style) and completed written and oral questionnaires to assess outcome measurements.

Main outcome measures were 1) preferences for a patient-centered versus a biomedical communication style; and 2) predictors of communication style preference. Participants who preferred the patient-centered style (69%; 95% confidence interval [CI], 63 to 75) tended to be younger (82% [51/62] for age < 30; 68% [100/148] for ages 30-59; 55% [21/38] for age > 59; P < .03), more educated (76% [54/71] for postcollege education; 73% [94/128] for some college; 49% [23/47] for high school only; P= .003), use CAM (75% [140/188] vs. 55% [33/60] for nonusers; P= .006), and have a patient-centered physician (88% [74/84] vs. 30% [16/54] for those with a biomedical physician; P < .0001). On multivariate analysis, factors independently associated with preferring the patient-centered style included younger age, use of herbal CAM, having a patient-centered physician, and rating a "doctor's interest in you as a person" as "very important."

Given that a significant proportion of patients prefer a biomedical communication style, practicing physicians and medical educators should strive for flexible approaches to physician-patient communication.