Heart specialists' art of care

Primary care physicians who encourage patients to interact in the medical interview receive high ratings of patient satisfaction with art of care. To determine if this finding holds true in specialty medicine, we designed a two-factor [art of care (high/low); heart specialty (cardiology/cardiovascular surgery)] four-group analogue study. Videotapes for each of the four conditions depicted the first interview between (actor) patient with coronary artery disease and (actor) specialist. The high art of care physicians elicited the patient's story in his own words and encouraged questions and feedback during the interview; the low art of care physicians did not encourage patient interaction. The cardiologists discussed medical treatment and the cardiovascular surgeons discussed surgical treatment. A pilot study of the instrument we developed indicated that the Art of Care Scale, Technical Quality of Care Scale, and Willingness to be Treated Scale demonstrated high internal consistency and that the Art of Care Scale and the Technical Quality of Care Scale defined two dimensions. In the final study, 124 graduate students in education in a midwestern United States university each viewed one videotape and used the instrument to evaluate the physician. Subjects rated the specialists who encouraged patients to interact higher on the Art of Care Scale than specialists who did not encourage interaction. Art of Care Scale Scores predicted subjects' willingness to be treated by the physician they viewed on the videotape. No significant differences in ratings of Art of Care could be attributed to specialty.