PHYSICIANS PSYCHOSOCIAL BELIEFS CORRELATE WITH THEIR PATIENT COMMUNICATION-SKILLS

OBJECTIVE: To assess the relationship between physicians' beliefs abou t the psychosocial aspects of patient care and their routine communica tion with patients. PARTICIPANTS AND SETTING: Fifty community primary care physicians participating in a continuing medical education progra m and 473 of their patients in Portland, Oregon. METHODS: Routine offi ce visits were audiotaped and analyzed for communication behaviors and emotional tone using the Roter Interactional Analysis System (RIAS), Physician beliefs about psychosocial aspects of care were measured usi ng a self-report questionnaire with a five-point Likert scale, Attitud es were correlated with communication behaviors using the Pearson corr elation coefficient. RESULTS: Physicians' attitudes toward psychosocia l aspects of care were associated with both physician and patient dial ogue in visits, The physicians who had positive attitudes used more st atements of emotion (i.e., empathy, reassurance) (p < 0.05) and fewer closed-ended questions (p < 0.01) than did their colleagues who had le ss positive attitudes, The patients of the physicians who had positive attitudes more actively participated in care (i.e., expressing opinio ns, asking questions), and these physicians provided relatively more p sychosocial and less biomedical information (p < 0.05). CONCLUSION: Ph ysician beliefs about psychosocial aspects of patient care are associa ted with their communication with patients in routine office visits, P atients of physicians with more positive attitudes have more psychosoc ial discussions in visits than do patients of physicians with less pos itive attitudes. They also appear more involved as partners in their c are, These findings have implications for medical educators, teachers, and practicing physicians.