EFFECTS OF A PHYSICIAN COMMUNICATION INTERVENTION ON PATIENT-CARE OUTCOMES

OBJECTIVE: To determine whether an intervention designed to improve pa tient-physician communication increases the frequency with which physi cians elicit patients' concerns, changes other communication behaviors , and improves health care outcomes. DESIGN: Pretest-posttest design w ith random assignment of physicians to intervention or control groups. SETTING: General medicine clinics of a university-affiliated Veterans Affairs Hospital. PATIENTS/PARTICIPANTS: Forty-two physicians and 348 continuity care patients taking prescription medications for chronic medical conditions. INTERVENTIONS: Intervention group physicians recei ved 4.5 hours of training on eliciting and responding to patients' con cerns and requests, and their patients filled out the Patient Requests for Services Questionnaire prior to a subsequent clinic visit, Contro l group physicians received 4.5 hours of training in medical decision- making. MEASUREMENTS AND MAIN RESULTS: The frequency with which physic ians elicited all of a patient's concerns increased in the interventio n group as compared with the control group (p = .032), Patients percep tions of the amount of information received from the physician did inc rease significantly (p < .05), but the actual magnitude of change was small. A measure of patient satisfaction with the physicians was high at baseline and also showed no significant change after the interventi on, Likewise, the intervention was not associated with changes in pati ent compliance with medications or appointments, nor were there any ef fects on outpatient utilization. CONCLUSIONS: A low-intensity interven tion changed physician behavior but had no effect on patient outcomes such as satisfaction, compliance, or utilization, Interventions may ne ed to focus on physicians and patients to have the greatest effect.