Effects of a physician communication intervention on patient care outcomes.

OBJECTIVE

To determine whether an intervention designed to improve patient-physician communication increases the frequency with which physicians elicit patients' concerns, changes other communication behaviors, and improves health care outcomes.

DESIGN

Pretest-posttest design with 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 received 4.5 hours of training on eliciting and responding to patients' concerns and requests, and their patients filled out the Patient Requests for Services Questionnaire prior to a subsequent clinic visit. Control group physicians received 4.5 hours of training in medical decision-making.

MEASUREMENTS AND MAIN RESULTS

The frequency with which physicians elicited all of a patient's concerns increased in the intervention group as compared with the control group (p = .032). Patients perceptions of the amount of information received from the physician did increase 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 intervention. Likewise, the intervention was not associated with changes in patient compliance with medications or appointments, nor were there any effects on outpatient utilization.

CONCLUSIONS

A low-intensity intervention changed physician behavior but had no effect on patient outcomes such as satisfaction, compliance, or utilization. Interventions may need to focus on physicians and patients to have the greatest effect.