Control, compliance, and satisfaction in the family practice encounter

With the current emphasis on patient-centered interviewing, issues of control behavior have become an important facet for understanding effective physician-patient communication. In this study, we describe how verbal control behaviors are manifested during the clinical encounter and how these control patterns relate to patient satisfaction and compliance.

Videotaped encounters (n = 50) in a family practice residency clinic were transcribed and analyzed using the Relational Communication Control Coding Scheme. In addition, we surveyed patients to assess levels of compliance and satisfaction.

Overall, patients showed assertive control patterns, and physicians manifested patterns of willingness to let patients take control of the conversation. The resulting outcomes showed that when physicians exhibited less control dominance, there was an increase in patient compliance and satisfaction.

The control patterns discovered are consistent with patient-centered viewpoints that encourage the patient's expression of ideas, concerns, and expectations. Increased levels of patient satisfaction and compliance were found when patients more assertively participated in the clinical conversation.