Authors: Ronald M Epstein Taj Hadee Jennifer Carroll Sean C Meldrum Judi Lardner Cleveland G Shields
Publish Date: 2007/10/31
Volume: 22, Issue: 12, Pages: 1731-1739
Abstract
To describe physicians’ responses to patients’ worries how their responses varied according to clinical context straightforward versus medically unexplained symptoms MUS and associations between their responses and patients’ ratings of interpersonal aspects of careMultimethod study For each physician we surveyed 50 current patients and covertly audiorecorded 2 unannounced standardized patient SP visits SPs expressed worry about “something serious” in 2 scenarios straightforward gastroesophageal reflux or poorly characterized chest pain with MUSPhysicians offered a mean of 31 responses to each of 613 SP prompts Biomedical inquiry and explanations action nonspecific acknowledgment and reassurance were common whereas empathy expressions of uncertainty and exploration of psychosocial factors and emotions were uncommon Empathy expressed during SP visits was associated with higher patient ratings of interpersonal aspects of care After adjusting for demographics and comorbidities the association was only statistically significant for the MUS role Empathy was most likely to occur if expressed at the beginning of the conversational sequenceWe would like to express thanks to David Seaburn PhD who helped with the initial conceptualization of this project Vi Luong provided graphic design support and Sue Palmiero and Mary Haddad provided secretarial and administrative support Some of the results reported in this article were presented at the International Conference on Communication in Healthcare Basel Switzerland September 7 2006 This study was funded by Patient Centered Care and Health Care Costs AHRQ R01HS161001A1 Ronald M Epstein Principal Investigator
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