Physician patient relationship and health outcomes research

physician patient relationship and health outcomes research

In the different studies the health outcomes encompass different dimensions, .. to assess interpersonal trust in patient-physician relationships. On Communication and Health Outcomes. Screen Shot “Time and the Patient – Physician Relationship”. Being a great physician. Trust; Communication; Patient satisfaction; Doctor-Patient relationship there has been on-going studies conducted on a doctor-patient relationship, trust and patient . et al. to know if trust in physicians was associated with health outcomes .

Emotional care includes mutual trust, empathy, respect, genuineness, acceptance and warmth [13]. Cognitive care includes information gathering, sharing medical information, patient education, and expectation management. Initially, our primary aim was to investigate the emotional component of the patient-clinician relationship.

However, most studies of the patient-clinician relationship include both cognitive and emotional care, and consequently, we expanded our focus to include these studies also. We note, however, that studies that do not separately measure emotional care while investigating communication interventions leave unclear which factor — emotional care or cognitive care — is responsible for any beneficial effects.

We also note that the boundary between cognitive care such as communications training and emotional care that enhances the patient-clinician relationship is unclear. For example, communications interventions often train clinicians to ask more open-ended questions, to resist interrupting patients, to identify and respond to patient expectations and fears, and to check patients' understanding of the diagnosis and recommended treatment. While these techniques are intended to improve the quality of information exchange, they are also likely to produce richer interpersonal interactions.

physician patient relationship and health outcomes research

Indeed, any intervention designed to improve communication — if effectively employed — is also likely to improve the quality of the interpersonal relationship.

Previous reviews have attempted to estimate the magnitude of the effect of relational factors on health outcomes and to discern the relative impact of discrete interventions and contextual factors [12][14][15][16][17]. Since the last review was published almost a decade ago, and in response to enormous changes in conceptual thinking about how best to restructure the delivery of healthcare services, we undertook an updated systematic review and meta-analysis examining whether the patient-clinician relationship has a beneficial effect on healthcare outcomes.

Reaffirming the Doctor-Patient Relationship - Stephen Sanders - TEDxSaintLouisUniversity

In contrast to previous reviews, we included in our review only randomized controlled trials RCTs that had either objective or validated subjective medical outcomes; and we excluded studies that only examined intermediate outcomes such as patient satisfaction or comprehension of medical advice.

Therefore, the current review focuses on the most rigorous sources of evidence to determine whether the relationship between patient and clinician can produce improvements in health. We report here on the thirteen studies that met our selection criteria for study design and methods. The exact electronic search strategy and a full description are provided in File S1.

Briefly, the electronic search strategy required that articles: For the review by hand, the inclusion criteria were: Studies were excluded if: For a detailed description of the inclusion and exclusion criteria, please see File S2. Collaborative decision-making leads to better management and better chances of compliance with treatment.

The current evidence suggests that patient-centered approach with effective communications skills and trust leads to better management and improved patient satisfaction. This is associated to better adherence to the treatmentbetter health outcomes and better perceived quality of healthcare services. Keywords Trust; Communication; Patient satisfaction; Doctor-Patient relationship Introduction Over the years, changing patterns in the society, advances in the medical care and easy access to medical information has made the doctor-patient relationship challenging [ 1 - 3 ].

Previously, the doctors were considered as the receptacle of all medical knowledge and this was used for patient management. The medical knowledge has become a commodity between the doctor and the patient and treatment is customized to individual patients [ 1 ]. This is a crucial note to keep in mind when it comes to managing patients. To provide the patient with high quality care, there needs to be a healthy doctor- patient relationship.

Communication and trust are the key elements among the other factors in building a healthy relationship [ 56 ]. Effective communication has always been one of the ingredients of success in all fields of work.

Trust in the health care professional and health outcome: A meta-analysis

Either it is field of economy or medicinehaving good communication skills is considered a ladder to success. In health care settings, trust and communication are labeled a tool for better patient care and patient satisfaction.

There is a necessity to have some degree of trust to build a climate in which honest communication can flourish. Effective and efficient communication is a predictor of medical practice and delivery of health care services [ 17 ]. The quality of interaction with the patients is positively related to trust and patient satisfaction. All of these are either direct or indirect measures of the quality of health care services [ 8 - 12 ].

In Pacific Island countries and developing country like Fiji, the quality of health care services has been questioned and considered generally low in quality by the public. These issues have been raised in the media, including social media whereby the public themselves are commenting on the healthcare quality. The South Pacific Situation Summary from the World Health Organization says that some of the Pacific Island countries' development efforts may bypass poor or most disadvantaged regions, and services are of low quality, especially for the poor [ 14 ].

Hence, considering this rapid social changes and advances in medical technology in the Pacific Island countries like Fiji as well, the changing doctor-patient relationship needs to be studied for improvements in health care services quality [ 15 - 17 ]. Also, for effective and efficient quality of health services, it is important for Individual countries to have an evidence-based policies or interventions in place [ 18 ].

Even though, there has been on-going studies conducted on a doctor-patient relationship, trust and patient satisfaction in other countries, there is limited studies done on patient satisfaction but none on trust in Fiji [ 1920 ].

Therefore, as one of the means to provide public with improved and optimal healthcare services, it is important that the healthcare providers understand and realize the importance of trust and communication in their relationship with the patients.

The purpose of this literature review is to gather the current knowledge on trust and communication in a doctor-patient relationship and highlight its importance towards service delivery with satisfied patients and quality of healthcare. The findings of this review will be of help to the health care providers, including ones in Fiji to realize the importance of building trust and communication.

physician patient relationship and health outcomes research

They can improve on the ways to build trust and improve their communication with patients, leading to better relationships and patient management. Also, as there are no current studies done in Fiji on patient trust and communication, this literature review attempts to prompt readers to conduct research on this topic.

These databases were chosen based on the usage of previous similar studies. All types of study design such as qualitative and quantitative studies were included in the search.

The search was limited to studies from year to till-date. A total of article titles related to the topic came up in the search. From these titles list, studies which were more closely related to the purpose of the review were shortlisted excluding some duplicate study noted.

From this list, second check for duplicates was done and after removal, there were 83 articles. Abstract of these 83 articles was screened. From this, excluding abstract of those articles that were not of interest, not in English and some that could not be accessed, 25 full text articles were screened. Some article titles were sent to my course supervisor to get the full article. From this list, the final 17 articles were selected and reviewed.

3 Studies Show Patient-Physician Interaction Affects Health Outcomes | MedXM

These articles were grouped into 3 categories for discussion; those studying trust and communication, patient satisfaction and healthcare quality. Literature Review - Trust and Communication Trust in doctor-patient relationship Trust is one of the essential components and fundamental part of doctor-patient relationship [ 56 ]. In general, to trust means to believe that someone is honest, nice or good, and will not harm you.

In the medical field for some patients, it can be their belief or expectation for the physician to behave in a certain way [ 21 ]. Patients might expect their health care provider to be competent, compassionate, honest, empathic, dependable and interested in their good will and expect a good outcome of their visit [ 2122 ].

Trust in a doctor-patient relationship is something that involves both confidence and reliance. The patients are put in a vulnerable situation where they believe that the care-providers will care for their interest [ 23 ]. For their own good, patients need to trust the doctors with their private information and body which is essential for their proper management [ 22 - 24 ].

Trust in the medical field can be considered as either institutional trust or interpersonal trust. For healthcare system, interpersonal trust is built, sustained or damaged through face to face encounters with health care providers. As for the institutional trust it is placed on the medical system or the institution.

The doctor-patient interaction is influenced by both personality and social systems and trust occurs in a framework of interaction which is influenced by both personality and social systems [ 25 ].

physician patient relationship and health outcomes research

Determinants of trust Despite its importance, trust is a complex and complicated subject that has been looked at with different perspective [ 21 ]. Though, the correlation of trust was low with the longitudinal continuity of the patient-physician relationship, preventive counseling, and the patient's financial access to care; r of 0. Depending on sociocultural context, different factor can give rise to trust as well.

Participants were selected using multistage sampling; men and women.

physician patient relationship and health outcomes research

They conducted a cross-sectional design using both qualitative and quantitative methods to study the determinants of the core dimensions of doctor-patient relationship. Fruitful trust is something that cannot just happen, rather it must be developed and maintained. Communication is one of the dimensions of physician behavior on which patients base their trust [ 21 ]. Communication and interpersonal skills are identified by the Accreditation Council for Graduate Medical Education as one of six areas in which doctors-in-training need to demonstrate competence in [ 29 ].

Improving the communication skills helps the doctors to build an effective relationship between doctors and patients. Russel reviewed literature on communication in the field of health care, specifically between the doctor and his or her patient. He stated that it is very important for healthcare professionals to recognize that communication interventions need to be individualized and that discrepancy can arise as the two individuals doctor and the patient might decode the same information differently [ 30 ].

Hence, from a clinical perspective, effective and efficient communication is a tool that helps doctors in providing quality care to their patients [ 31 ]. Physicians with good communication and interpersonal skills tend to gather a proper history from the patient, which guides the appropriate examinations and then management [ 7 ]. It facilitates exchange of information and includes patients in decision making.

physician patient relationship and health outcomes research

Determinants of effective communication In the first encounter of doctors with the patients, use of questions by the doctor can aid in the free flow of information from the patient to the doctor. Swasey in her thesis mentions that in this first interaction, doctors can use open-ended question to guide the conversation in-order to get appropriate information needed for proper diagnosis and management.

Studies have shown that trust is closely related and somewhat influenced by the health care providers' communication skills [ 6222533 ]. There has been a shift from the problem focused communication to solution focused communication which is evident to the lay people as well [ 34 ]. A study was conducted by Butalid et al.

The mixed methodology type was used for the analogue patients with hypertension to assess the videotaped consultation between 2 periods; in s and in s. The study found that participants recognize listening, giving support and showing respect were consistent themes in both the time periods. The authors concluded that aspects of the medical interaction that patients value are evidence-based medicine and attention to the process of shared decision making.

Studies have demonstrated patient discontent even when many doctors considered the communication adequate or even excellent [ 36 ].

  • Trust in the health care professional and health outcome: A meta-analysis
  • Can Empathy Be As Effective As Aspirin? The Patient-Clinician Relationship Affects Medical Outcomes
  • News Release

Currently, there is a greater expectation of collaborative decision making. Physicians and patients participate as partners to achieve the agreed upon goals and the attainment of quality of life [ 7 ]. Trust, communication and patient satisfaction Studies have shown that patient satisfaction is positively correlated with communication skills [ 37 ].

This included patients willing to participate, spoke English, first admission within the study period and those who completed their 1-month follow-up questionnaire. Small changes in doctor communication behaviors can make some significant changes in patient satisfaction [ 36 ]. Similar findings were noted in another study [ 31 ]. The study concluded that doctors should be having regular workshops to improve their communication skills.

3 Studies Show Patient-Physician Interaction Affects Health Outcomes

Although, interpersonal-based medical service encounter directly affects patient satisfaction, patient trust is used as intervening variable to affect patient satisfaction, which represents an indirect effect [ 37 ]. They conducted a cross-sectional study using a questionnaire in seven medical centers of Taiwan.

Participants were recruited under volunteer basis; from a total of participants, valid copies were retrieved. Hospitals are recommended to enhance professional skills and communication, attitudes of personnel to build adequate trust and retain patients [ 38 ].

Trust and Communication in a Doctor- Patient Relationship: A Literature Review.

When it comes to patients with chronic disease, trust and communication carry the same value in their satisfaction with the care provided. There is a need for doctors to develop good interpersonal and communicating skills in-order to have an effective and quality doctor-patient interaction with their diabetic patients.

For all the patients attending public diabetic clinic in the province of Punjab in Pakistan, 1, patients who were 18 years over, had diabetes and made at least three previous visits to the same clinic were included in the study.