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The clinician-patient partnership paradigm: outcomes associated with physician communication behavior
Noreen M Clark1, Michael D Cabana, Bin Nan
1Center for Managing Chronic Disease University of Michigan, Ann Arbor, MI 48109-2029, USA. nmclark@umich.edu
Objective:
To identify physician communication behaviors associated with perceptions of quality of care and predictive of positive patient outcomes.
Patients And Methods:
A total of 452 families seeing 48 pediatricians for a child's asthma participated. Perceptions and health care use were assessed at baseline and after 12 months through interviews and medical records. The measures used were 10 physician communication behaviors and 6 items describing physician's performance, asthma office visits, emergency department visits, and hospitalization.
Results:
Positive perceptions of physicians' performance were related to (P < or = .05) careful listening, inquiring about at-home management, nonverbal attention, interactive conversation, tailoring short-term goals, and long-term therapeutic plan. Loss in health care use was predicted (P < or = .05) by interactive conversation, short-term goals, criteria for decision making, long-term treatment plan, and tailoring according to needs. The use of these techniques did not lengthen the patient visit. A clinician-patient partnership paradigm is provided based on these findings.
Conclusions:
The specific clinician communication behaviors predicted reduced health care use and positive perceptions of quality of care.
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