The Impact of Patient Participation on Physicians' Information Provision During a Primary Care Medical Interview

Abstract

This study investigated the impact of patients' participation on physicians' information provision during a primary care medical interview. When communicating with high-participation patients, physicians provided significantly more information overall, more information in response to patients' questions, and volunteered more information than when interacting with low-participation patients. The most significant differences with respect to volunteered information involved communication about treatment and tests or procedures. These results were interpreted to suggest that high-participation patients' communication style promotes better alignment of patients' and physicians' goals and agendas.

Overall, the results suggest that patients' style of participation during a medical interview significantly influenced the extent and type of information physicians provided. Given that patients' biggest complaint about physicians often is a lack of desired information, this study has important implications for physician–patient communication.

ACKNOWLEDGMENTS

Data for Sample 1 were made possible by Grant R03 HS90110-01T from the former Agency for Health Care Policy and Research, now the Agency for Healthcare Research and Quality. Data for Sample 2 were made possible by a grant from the Crisafi-Monti Endowment Fund, College of Medicine and Public Health, The Ohio State University. Data for Sample 3 were made possible by a grant from the Miller Research Funds, School of Communication, The Ohio State University, and by the Department of Family and Community Medicine, Wake Forest University School of Medicine through Grant D32-PE-10230-01 from the Health Resources and Services Administration. Geeta George and Tiffini Williamson are acknowledged for their specific contributions of data collection on the Wake Forest University School of Medicine grant.

Notes

¹Note that this reliability reflects the consistency across the four components of the patient participation index. Ideally, high-participation patients would have high frequencies for all components, but particular circumstances of a given interview may render one or more components less relevant (e.g., no negative or positive emotions were experienced, there were no relevant concerns to express). This likely accounts for the alpha being slightly lower than the customary minimum of .70. However, a lower alpha across component scores is not uncommon (Antony, 2001), and alphas even as low as .49 still have an upper limit of validity of .70 (Schmitt, 1996).