DOCTOR-PATIENT COMMUNICATION - A REVIEW OF THE LITERATURE

Communication can be seen as the main ingredient in medical care. In r eviewing doctor-patient communication, the following topics are addres sed: (1) different purposes of medical communication; (2) analysis of doctor-patient communication; (3) specific communicative behaviors; (4 ) the influence of communicative behaviors on patient outcomes; and (5 ) concluding remarks. Three different purposes of communication are id entified, namely: (a) creating a good inter-personal relationship; (b) exchanging information; and (c) making treatment-related decisions. C ommunication during medical encounters can be analyzed by using differ ent interaction analysis systems (IAS). These systems differ with rega rd to their clinical relevance, observational strategy, reliability/va lidity and channels of communicative behavior. Several communicative b ehaviors that occur in consultations are discussed: instrumental (cure oriented) vs affective (care oriented) behavior, verbal vs non-verbal behavior, privacy behavior, high vs low controlling behavior, and med ical vs everyday language vocabularies. Consequences of specific physi cian behaviors on certain patient outcomes, namely: satisfaction, comp liance/adherence to treatment, recall and understanding of information , and health status/psychiatric morbidity are described. Finally, a fr amework relating background, process and outcome variables is presente d.