How perceptions of a simulated physician-patient interaction influence intended satisfaction and compliance

A frequent problem encountered in the evaluation of medical services is that patients intertwine or confound perceptions of technical medical skills (competence) with those of interpersonal and communication skills (courtesy). The present study investigated the extent to which competence and courtesy influenced enacted patient perceptions of medical care; as well as how those perceptions related to satisfaction and compliance with the care delivered. Small groups of undergraduates viewed one of four videotapes on which were depicted a physician-patient interaction for a sore throat problem. Differential levels of competence and courtesy were displayed in the various tapes. While watching the videotape, subjects were asked to assume the role of the sore throat patient. Factor analysis of semantic differential items administered subsequent to the videotapes revealed the presence of two strong and distinct clusters, one labeled courtesy and the other competence. Univariate ANOVAs indicated that the courtesy manipulation influenced the perception of courtesy and general medical satisfaction, while the competence manipulation influenced not only perceived competence but perceived courtesy, general medical satisfaction, and compliance as well. Subjects were able to accurately discriminate the extremes of good and poor physician behavior. The limitations of the study as well as its implications for developing better understanding of how perceptions of health care providers are formed were explored.