Doctors Talking with Patients/Patients Talking with Doctors: Improving Communication in Medical Visits

By Debra L. Roter; Judith A. Hall | Go to book overview

8
Consequences of Talk: The Relationship of Talk to Patient Outcomes

To study the process of medical care, one focuses primarily on the physician. But the patient becomes the center of attention when one turns to the consequences of that care. The patient perspective has been investigated in terms of perception--how satisfied the patient is with care received; it has been investigated in terms of patient behavior--how likely the patient is to comply with therapeutic regimens; and, finally, in terms of effect--how much better the patient is as a result of care.

Predominantly, communication researchers interested in patient consequences have studied the first two outcomes: patient satisfaction with care and compliance with doctors' recommendations. Dissatisfied patients are less likely to return for visits and more likely to switch doctors and health plans. Dissatisfaction, because it implies low trust, also surely undermines the nonspecific healing mechanisms implied in placebo and suggestion effects. And a dissatisfied patient almost by definition will miss out on the rapport and reassurance that is part of a good doctor-patient relationship. Satisfaction is also linked with patient compliance--more satisfied patients are more likely to follow medical recommendations.

Medical recommendations run the gamut from taking a single pill or following a complex drug regimen, to seeking preventive care and returning for follow-up appointments, to modifying aspects of one's lifestyle. Noncompliance with recommendations jeopardizes patients' health and well-being, interferes with the doctor's therapeutic efforts, and leads to wasted health resources ( DiMatteo & DiNicola, 1982). Failure to follow drug regimens adequately, for instance, has been linked to diminished

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