Communication patterns of primary care physicians

D. L. Roter, M. Stewart, S. M. Putnam, Jr Lipkin M., W. Stiles, Thomas Inui

Research output: Contribution to journalArticle

737 Citations (Scopus)

Abstract

Objectives. - To use audiotape analysis to describe communication patterns in primary care, to relate these to ideal relationship types as described in the literature, and to explore the patterns' relationships with physician and patient characteristics and satisfaction. Design. - Description of routine communication in primary care based on audiotape analysis and patient and physician exit questionnaires. Setting. - A total of 11 ambulatory clinics and private practices. Participants. - The participants were 127 physicians and 537 patients coping with ongoing problems related to disease, Main Outcomes Measures. - Roter Interactional Analysis System (RIAS) and patient and physician exit satisfaction questionnaires. Results. - Cluster analysis revealed 5 distinct communication patterns: (1) 'narrowly biomedical,' characterized by dosed-ended medical questions and biomedical talk occurring in 32% of visits; (2) 'expanded biomedical,' like the restricted pattern but with moderate levels of psychosocial discussion occurring in 33% of the visits; (3) 'biopsychosocial,' reflecting a balance of psychosocial and biomedical topics (20% of the visits); (4) 'psychosocial,' characterized by psychosocial exchange (8% of visits); and (5) 'consumerist,' characterized primarily by patient questions and physician information giving (8% of visits). Biomedically focused visits were used more often with more sick, older, and lower income patients by younger, male physicians. Physician satisfaction was lowest in the narrowly biomedical pattern and highest in the consumerist pattern, while patient satisfaction was highest in the psychosocial pattern. Conclusions. - Primary care communication patterns range from narrowly biomedical to consumerist patterns and parallel the ideal forms of patient-physician relationships described in the literature.

Original languageEnglish (US)
Pages (from-to)350-356
Number of pages7
JournalJournal of the American Medical Association
Volume277
Issue number4
StatePublished - 1997
Externally publishedYes

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Primary Care Physicians
Communication
Physicians
Tape Recording
Primary Health Care
Patient Satisfaction
Physician-Patient Relations
Private Practice
Cluster Analysis
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Roter, D. L., Stewart, M., Putnam, S. M., Lipkin M., J., Stiles, W., & Inui, T. (1997). Communication patterns of primary care physicians. Journal of the American Medical Association, 277(4), 350-356.

Communication patterns of primary care physicians. / Roter, D. L.; Stewart, M.; Putnam, S. M.; Lipkin M., Jr; Stiles, W.; Inui, Thomas.

In: Journal of the American Medical Association, Vol. 277, No. 4, 1997, p. 350-356.

Research output: Contribution to journalArticle

Roter, DL, Stewart, M, Putnam, SM, Lipkin M., J, Stiles, W & Inui, T 1997, 'Communication patterns of primary care physicians', Journal of the American Medical Association, vol. 277, no. 4, pp. 350-356.
Roter DL, Stewart M, Putnam SM, Lipkin M. J, Stiles W, Inui T. Communication patterns of primary care physicians. Journal of the American Medical Association. 1997;277(4):350-356.
Roter, D. L. ; Stewart, M. ; Putnam, S. M. ; Lipkin M., Jr ; Stiles, W. ; Inui, Thomas. / Communication patterns of primary care physicians. In: Journal of the American Medical Association. 1997 ; Vol. 277, No. 4. pp. 350-356.
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