Relationship, Communication, and Efficiency in the Medical Encounter<subtitle>Creating a Clinical Model From a Literature Review</subtitle>
Archives of Internal MedicinePublished 14 July 2008
Larry Mauksch
Citations279
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
A model blending the quality-enhancing and time management features of selected communication and relationship skills is offered: rapport building, up-front agenda setting, and acknowledging social or emotional clues.
Abstract
Building on these findings, we offer a model blending the quality-enhancing and time management features of selected communication and relationship skills. There is a need for additional research about communication skills that enhance quality and efficiency.
Keywords
MedicineHealth Professions
American PsychologistSelf-determination theory and the facilitation of intrinsic motivation, social development, and well-being.
27,592 Citations2000Richard M. Ryan, Edward L. Deci
PubMedEffective physician-patient communication and health outcomes: a review.
4,076 Citations1995Moira Stewart
The quality of communication both in the history-taking segment of the visit and during discussion of the management plan was found to influence patient health outcomes.
PubMedThe impact of patient-centered care on outcomes.
2,497 Citations2000Moira Stewart, Judith Belle Brown +5 more
Positive perceptions of patient-centered communication were associated with better recovery from their discomfort and concern, better emotional health 2 months later, and fewer diagnostic tests and referrals.
American Journal of Public HealthPrimary Care: Is There Enough Time for Prevention?
1,660 Citations2003Kimberly S. H. Yarnall, Kathryn I. Pollak +3 more
The amount of time required for a primary care physician to provide recommended preventive services to an average patient panel using published and estimated times per service was determined.
JAMAPhysician-patient communication. The relationship with malpractice claims among primary care physicians and surgeons
1,527 Citations1997Warren Levinson
Patient-Centered Medicine: Transforming the Clinical Method
1,300 Citations1995Moira Stewart, Judith Belle Brown +4 more
The Patient-Centered Clinical Method and the Human Dimensions of Medical Education: Dealing with Common Difficulties in learning and teaching.
Annals of Internal MedicineCollaborative Management of Chronic Illness
1,277 Citations1997Michael Von Korff, Jessie Gruman +3 more
This work identified essential elements of collaborative management of chronic illness in light of behavioral principles and empirical evidence about enhancement of self-care, and discussed critical next steps to improve care of Chronic illness in organized health care systems.
Social Science & MedicineMeasuring patient-centered communication in Patient–Physician consultations: Theoretical and practical issues
1,209 Citations2005Ronald M. Epstein, Peter Franks +5 more
Nine areas for improvement in measuring patient-centered communication are proposed: developing theory-based operational definitions of PCC, clarifying what is being measured, validating of instruments, and examining pathways and mediators of links between PCC and outcomes.
PubMedInformed decision making in outpatient practice: time to get back to basics.
1,155 Citations1999Clarence H. Braddock, K. A. Edwards +3 more
Informed decision making among this group of primary care physicians and surgeons was often incomplete, and this deficit was present even when criteria for informed decision making were tailored to expect less extensive discussion for decisions of lower complexity.
Social Science & MedicineWhy do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse
1,148 Citations1997John Lynch, George A. Kaplan +1 more
Data from the Kuopio Ischaemic Heart Disease Risk Factor Study were used to examine the associations between measures of SES reflecting different stages of the lifecourse, health behaviours, and psychosocial characteristics in adulthood in a population-based study of 2674 middle-aged Finnish men.
The Annals of Family MedicinePrevalence of Multimorbidity Among Adults Seen in Family Practice
989 Citations2005Martin Fortin
The prevalence of multimorbidity in family practice patients is quite high and increases significantly with age in both men and women, whether measured by simply counting the number of conditions or using the Cumulative Illness Rating Scale (CIRS).
Annals of Internal MedicineThe Effect of Physician Behavior on the Collection of Data
964 Citations1984Howard Beckman, RICHARD M. FRANKEL
Doctors play an active role in regulating the quantity of information elicited at the beginning of the clinical encounter, and use closed-ended questioning to control the discourse, resulting in the premature interruption of patients.
The American Journal of MedicineCommon symptoms in ambulatory care: Incidence, evaluation, therapy, and outcome
951 Citations1989Kurt Kroenke, A. David Mangelsdorff
The classification, evaluation, and management of common symptoms need to be refined, and diagnostic strategies emphasizing organic causes may be inadequate.
JAMACommunication Patterns of Primary Care Physicians
926 Citations1997Debra L. Roter
Primary care communication patterns range from narrowly biomedical to consumerist patterns and parallel the ideal forms of patient-physician relationships described in the literature.
Academic MedicineEssential Elements of Communication in Medical Encounters
879 Citations2001Gregory Makoul
A coherent set of essential elements in physician—patient communication is delineated to facilitate the development, implementation, and evaluation of communication-oriented curricula in medical education and inform the development of specific standards in this domain.
JAMAClinical Empathy as Emotional Labor in the Patient-Physician Relationship
873 Citations2005Eric B. Larson
It is contended that physicians are more effective healers--and enjoy more professional satisfaction--when they engage in the process of empathy.
PubMedLinking primary care performance to outcomes of care.
860 Citations1998Dana Gelb Safran, Deborah A. Taira +4 more
Patients' trust in their physician and physicians' knowledge of patients are leading correlates of three important outcomes of care, including adherence to physician's advice, patient satisfaction, and improved health status.
JAMAA Model of Empathic Communication in the Medical Interview
783 Citations1997Anthony L. Suchman
Based on observations, the basic empathic skills seem to be recognizing when emotions may be present but not directly expressed, inviting exploration of these unexpressed feelings, and effectively acknowledging these feelings so the patient feels understood.
PubMedEmpathy and quality of care.
776 Citations2002Stewart W Mercer, William Reynolds
Empathy is a complex multi-dimensional concept that has moral cognitive emotive and behavioural components and studies in mental health and in nursing suggest it plays a key role.
PubMedSoliciting the patient's agenda: have we improved?
736 Citations1999M. Kim Marvel, Ronald M. Epstein +2 more
The Annals of Family MedicineIs There Time for Management of Patients With Chronic Diseases in Primary Care?
711 Citations2005Truls Østbye
Streamlined guidelines and alternative methods of service delivery are needed to meet recommended standards for quality health care.
JAMAA Study of Patient Clues and Physician Responses in Primary Care and Surgical Settings
663 Citations2000Wendy Levinson
It is suggested that physicians in both primary care and surgery can improve their ability to respond to patient clues even in the context of their busy clinical practices.
Journal of General Internal MedicineTime and the patient-physician relationship
592 Citations1999David C. Dugdale, Ronald M. Epstein +1 more
The effects of limiting time on the patient-doctor relationship is examined, including the effects that are attributable to managed care, and recommendations for teaching medical students and residents skills that will help establish and maintain their patient- doctor relationships in the face of time pressure.
Family ProcessHypothesizing, Circularity, and Neutrality Revisited: An Invitation to Curiosity
585 Citations1987Gianfranco Cecchin
This essay examines the systemic guiding principles of neutrality, hypothesizing, and circularity, historically developed by the Milan Team of Selvini-Palazzoli, Boscolo, Cecchin, and Prata.
BMJPatients' unvoiced agendas in general practice consultations: qualitative study
580 Citations2000Christine A. Barry
Investigation of patients' agendas before consultation and the effects of unvoiced agendas on outcomes suggests that when patients and their needs are more fully articulated in the consultation better health care may be effected.
BMJConsultation length in general practice: cross sectional study in six European countries
514 Citations2002Myriam Deveugele, Anselm Derese +3 more
Analysis of videotaped consultations of general practitioners from the Eurocommunication study and of questionnaires completed by doctors and by patients found that consultation length is determined by variables related to the doctor and the doctor's country as well as by those related to patients.
JAMAEffect of Communications Training on Medical Student Performance
475 Citations2003Michael J. Yedidia
Communications curricula using an established educational model significantly improved third-year students' overall communications competence as well as their skills in relationship building, organization and time management, patient assessment, and negotiation and shared decision making-tasks that are important to positive patient outcomes.
Health Services ResearchTime Allocation in Primary Care Office Visits
473 Citations2007Ming Tai‐Seale, Thomas G. McGuire +1 more
An innovative videotape analysis method was used to examine how clinic time was spent during elderly patients' visits to primary care physicians, finding many topics compete for visit time, resulting in small amount of time being spent on each topic.
Medical CareCommunication Interventions Make A Difference in Conversations Between Physicians and Patients
472 Citations2007Jaya K. Rao, Lynda A. Anderson +2 more
The interventions were associated with improved physician and patient communication behaviors and the challenge for future research is to design effective patient and physician interventions that can be integrated into practice.
PubMedEvidence on patient-doctor communication.
454 Citations1999Moira Stewart, Janis Brown +4 more
This chapter covers important and well-studied aspects of patient-doctor communication, including communication in relation to patient adherence with the management plan recommended by the doctor and the final topic is patients' health.
JAMACalibrating the Physician
450 Citations1997Dennis H. Novack
A "curriculum" of 4 core topics for reflection and discussion of physicians' beliefs and attitudes, physicians' feelings and emotional responses in patient care, challenging clinical situations, and physician self-care is proposed.
Journal of General Internal MedicineReducing Patients’ Unmet Concerns in Primary Care: the Difference One Word Can Make
432 Citations2007John Heritage, Jeffrey D. Robinson +3 more
Patients’ unmet concerns can be dramatically reduced by a simple inquiry framed in the SOME form, and both the learning and implementation of the intervention require very little time.
Journal of General Internal MedicineManaged care, time pressure, and physician job satisfaction: Results from the physician worklife study
418 Citations2000the Society of General Internal Medicine (SGIM) Career Satisfaction Study Group (CSSG), Mark Linzer +10 more
HMO physicians are generally less satisfied with their jobs and more likely to intend to leave their practices than physicians in many other practice settings and the data suggest that HMO physicians’ satisfaction with staff, community, resources, and the duration of new patients visits should be assessed and optimized.
The Annals of Family MedicinePatient-Centered Communication and Diagnostic Testing
372 Citations2005Ronald M. Epstein
Patient-centered communication is associated with fewer diagnostic testing expenditures but also with increased visit length, an effect primarily associated with the effect on testing expenditures.
JAMACalibrating the physician. Personal awareness and effective patient care. Working Group on Promoting Physician Personal Awareness, American Academy on Physician and Patient
371 Citations1997Dennis H. Novack
A "curriculum" of 4 core topics for reflection and discussion of physicians' beliefs and attitudes, physicians' feelings and emotional responses in patient care, challenging clinical situations, and physician self-care is proposed.
American Journal of Public HealthThe influence of patient-practitioner agreement on outcome of care.
365 Citations1981Bárbara Starfield, Chris R. Wray +4 more
The findings of this study confirm those of the previous study in suggesting that practitioner-patient agreement about problems is associated with greater expectations for improvement and with better outcome as perceived by patients and indicate that practitioners also report better outcome under the same circumstances.
New England Journal of MedicineAre Patients' Office Visits with Physicians Getting Shorter?
360 Citations2001David Mechanic, Donna McAlpine +1 more
BMJQuality at general practice consultations: cross sectional survey
352 Citations1999J. G. R. Howie, David Heaney +4 more
It may be time to reward doctors who have longer consultations, provide greater continuity of care, and both enable more patients and enable patients more.
The Joint Commission Journal on Quality and SafetyImplementing Practical Interventions to Support Chronic Illness Self-Management
343 Citations2003Russell E. Glasgow, Connie L. Davis +2 more
Self-management should be an integral part of primary care, an ongoing iterative process, and patient centered; use collaborative goal setting and decision making; and include problem solving, outreach, and systematic follow-up.
Medical EducationPhysician communication skills training: a review of theoretical backgrounds, objectives and skills
319 Citations2002Donald J. Cegala, Stefne Lenzmeier Broz
Competence in communication skills training for practising doctors and the importance of competent communication to the doctor–patient relationship and health care in general is highlighted.
Annals of Internal Medicine“Let Me See If I Have This Right …”: Words That Help Build Empathy
319 Citations2001John L. Coulehan, Frederic W. Platt +5 more
Empathy is the ability to understand the patient's situation, perspective, and feelings and to communicate that understanding to the patient and the effective use of empathy promotes diagnostic accuracy, therapeutic adherence, and patient satisfaction, while remaining time-efficient.
The Annals of Family MedicineThe Meaning Of Healing: Transcending Suffering
314 Citations2005Thomas R. Egnew
Healing may be operationally defined as the personal experience of the transcendence of suffering and Physicians can enhance their abilities as healers by recognizing, diagnosing, minimizing, and relieving suffering, as well as helping patients transcend suffering.
The American Journal of MedicineDepressive and Anxiety Disorders in Patients Presenting With Physical Complaints
294 Citations1997Kurt Kroenke, Jeffrey L. Jackson +1 more
Simple clinical clues in patients with physical complaints identify a subgroup who may warrant further evaluation for a depressive or anxiety disorder, which are associated with unmet patient expectations and increased provider frustration.
PubMedThe relationship between consultation length, process and outcomes in general practice: a systematic review.
273 Citations2002Andrew Wilson, Susan Childs
There were consistent differences in several elements of process and outcome between general practitioners who consult at different rates and the evidence suggests that patients seeking help from a doctor who spends more time with them are more likely to have a consultation that includes important elements of care.
General Hospital PsychiatryCompeting demands in psychosocial care
268 Citations1997Michael S. Klinkman
Using the model as a framework to guide inquiry into the identification and management of depression and other mood disorders in primary care may lead to the discovery of more creative and effective solutions to the problem of underdiagnosis and undertreatment.
The Hastings Center ReportTransparency: Informed Consent in Primary Care
255 Citations1989Howard Brody
A “transparency” model that sees consent as a conversation process can enhance good medical practice and patient autonomy without foreclosing appropriate judicial review.
British Journal of Health PsychologyA systematic review of motivational interviewing in physical health care settings
254 Citations2006Katherine M. Knight, Linda McGowan +2 more
While MI has high face validity across a number of domains in physical health care settings, the general quality of trials in this area is inadequate and therefore recommendations for its dissemination in this areas cannot yet be made.
PubMedPatient satisfaction with time spent with their physician.
247 Citations1998David A. Gross, Stephen J. Zyzanski +3 more
Physicians can enhance patient satisfaction with the amount of time spent during an office visit by spending a small proportion of time chatting about nonmedical topics, and by allowing sufficient time for exchange with the patient is feedback is necessary.
PubMedRelationships between physician practice style, patient satisfaction, and attributes of primary care.
234 Citations2002Susan A. Flocke, William L. Miller +1 more
In community-based practices, it is found that the person-focused interaction style appears to be the most congruent with patient reported quality of primary care.
Annals of Internal MedicineThe Effectiveness of Intensive Training for Residents in Interviewing
231 Citations1998Robert C. Smith, Judith S. Lyles +10 more
An intensive training program for primary care residents in interviewing and related psychosocial topics in medicine is developed and tested, finding that the patients of trained residents would have greater satisfaction, fewer somatic symptoms, less social dysfunction, less depression and anxiety, and reduced functional disability.
BMJSpontaneous talking time at start of consultation in outpatient clinic: cohort study
227 Citations2002Wolf Langewitz, Martin Denz +4 more
It is examined how long it would take outpatients at a tertiary referral centre to indicate that they have completed their story—for example, with a statement such as: “That's all, doctor!” if uninterrupted by their doctors.
PubMedMedically unexplained symptoms in primary care.
214 Citations1998Wayne Katon, Edward A. Walker
Evidence will be presented demonstrating that an increasing number of medically unexplained symptoms over a patient's lifetime correlate linearly with the number of anxiety and depressive disorders experienced, the score on the personality dimension of neuroticism, and the degree of functional impairment.
Annals of Internal MedicinePrevalence and Sources of Patients' Unmet Expectations for Care
210 Citations1996Richard L. Kravitz, Edward J. Callahan +4 more
Patients' expectations for medical care are of increasing interest to clinicians, policymakers, and researchers and further understanding of patients' expectations could improve the clinical process of care, health care delivery systems, and health services research.
Medical CareProblems and Prospects for Health Services Research on Provider-Patient Communication
207 Citations1985Thomas S. Inui, William B. Carter
The Annals of Family MedicineThreads and Yarns: Weaving the Tapestry of Comorbidity
196 Citations2006Bárbara Starfield
As any weaver knows, the elegance of a fabric lies in the yarns, not the threads, and in health services, the threads are the diagnoses on which interventions are based.
BMJEvolving general practice consultation in Britain: issues of length and context
193 Citations2002George Freeman, John P Horder +5 more
The systematic review consistently showed that doctors with longer consultation times prescribe less and offer more advice on lifestyle and other health promoting activities.
Archives of Family MedicineClues to Patients' Explanations and Concerns About Their Illnesses: A Call for Active Listening
179 Citations2000Forrest Lang
A taxonomy of clues is proposed that includes expression of feelings, attempts to understand or explain symptoms, speech clues that underscore particular concerns of the patient, personal stories that link the patient with medical conditions or risks, and behaviors suggestive of unresolved concerns or unmet expectations to help physicians recognize patients' clues more readily and improve their active listening skills.
Journal of General Internal MedicineOh, by the way …
174 Citations1994Jocelyn White, Wendy Levinson +1 more
Orienting patients in the flow of the visit, assessing patient beliefs, checking for understanding, and addressing emotions and psychosocial issues early on may decrease the number of new problems in the final moments of theVisit.
Journal of General Internal MedicineOrganizational Dimensions of Relationship-centered Care. Theory, Evidence, and Practice
172 Citations2006Dana Gelb Safran, William L. Miller +1 more
It is concluded that turning attention to relationship-centered theory and practice in health care holds promise for advancing care to a new level, with breakthroughs in quality of care, quality of life for those who provide it, and organizational performance.
Health CommunicationExamining Empathy in Medical Encounters: An Observational Study Using the Empathic Communication Coding System
168 Citations2005Carma L. Bylund, Gregory Makoul
Overall, patients presented 249 empathic opportunities in these 100 visits; physicians most often responded by acknowledging, pursuing, or confirming the patient's statement, and there was no relation between the emotional intensity of empathy opportunities and the level of empathy in subsequent physician responses.
Journal of General Internal MedicineThe effect of physician solicitation approaches on ability to identify patient concerns
167 Citations2005Lawrence Dyche, Deborah Swiderski
Interruption as defined by Beckman-Frankel does not curtail ability to identify patient concerns, but failure to ask for the patient’s agenda associates with a 24% reduction in physician understanding.
PubMedThe physician's actions and the outcome of illness in family practice.
167 Citations1986Martin J. Bass, Colin Buck +4 more
The outcome of new episodes of common nonrespiratory tract symptoms was studied and late resolution was associated with the physician's recording of attention to psychosocial problems.
The Annals of Family MedicineHow Many Problems Do Family Physicians Manage at Each Encounter? A WReN Study
164 Citations2004John W. Beasley
A mismatch between family medicine and current approaches to quality assessment, guideline implementation, education, research, administration, and funding needs to be addressed to address the physician’s task of prioritizing and integrating care for multiple problems concurrently.
The Annals of Family MedicinePreventing Errors in Clinical Practice: A Call for Self-Awareness
155 Citations2004Francesc Borrell Carrió
A so-called rational-emotive model is proposed that emphasizes 2 factors in error causation: difficulty in reframing the first hypothesis that goes to the physician’s mind in an automatic way, and premature closure of the clinical act to avoid confronting inconsistencies, low-level decision rules, and emotions.
PubMedThe duration of ambulatory visits to physicians.
142 Citations1999David Blumenthal, Nancyanne Causino +6 more
Clinicians, policymakers, and health system managers should take these considerations into account in managing physician resources during daily ambulatory practice.
Medical CareThe Organization of Medical Practice and Practice Orientations Among Physicians in Prepaid and Nonprepaid Primary Care Settings
123 Citations1975David Mechanic
The data suggest that the patient load characteristic of general practice in prepaid groups encourages a more assembly line practice which is less responsive to patients than the pattern characteristic of fee-for-service practice.
PubMedConsultation length, patient-estimated consultation length, and satisfaction with the consultation.
112 Citations2002John Cape
Correlational analysis of patients from nine GP practices was used to test the hypothesis that patients' perceptions of consultation length are influenced not just by actual consultation length, but by other aspects of their experience of consultations.
PubMedThe importance of empathy in the enablement of patients attending the Glasgow Homoeopathic Hospital.
110 Citations2002Stewart W Mercer, David Reilly +1 more
Investigating patient enablement in a setting where time is less of a constraint than in primary care, in order to determine the importance of other factors in enablement found empathy to be the single most important factor.
Journal of General Internal MedicineThe doctor will see you shortly
108 Citations2005Clarence H. Braddock, Lois Snyder
Specific strategies—many of which do not take significantly more time—can effectively change the perception that time is inadequate and are critical for clinicians and health systems to maintain their ethical commitments and simultaneously deal with the realities of time.
PubMedTrade-offs in high-volume primary care practice.
105 Citations1998S. J. Zyzanski, Kurt C. Stange +2 more
Physicians with high-volume practices are more efficient in providing similar services in a shorter amount of time, but this greater apparent efficiency may come at a cost of lower rates of preventive services delivery, lower patient satisfaction, and a less positive doctor-patient relationship.
JAMAPatient-Doctor Agreement About Problems Needing Follow-up Visit
103 Citations1979Bárbara Starfield
It is believed greater patient participation in the processes of care should result in better follow-up of problems and better results, at least as perceived by patients.
Oxford Textbook of Primary Medical Care
103 Citations2004Roger Jones
Journal of General Internal MedicineCommunication patterns of primary care physicians in the United States and the Netherlands
101 Citations2003Jozien M. Bensing, Debra Roter +1 more
U.S. and Dutch primary care visits showed substantial differences in communication patterns and visit length, which may reflect country distinctions in medical training and philosophy, health care system characteristics, and cultural values and expectations relevant to the delivery and receipt of medical services.
PubMedAddressing multiple problems in the family practice office visit.
98 Citations2001Susan A. Flocke, Scott Frank +1 more
The findings suggest that current views of physician productivity and the billing record are poor indicators of the reality of providing primary care.
BMJHow should hamsters run? Some observations about sufficient patient time in primary care
93 Citations2001David Mechanic
Although the consensus in the United States has been that managed care has required substantial reductions in the time that patients spend with their doctor, consultation time increased between 1989 and 1998 for prepaid and non-prepaid visits.
The Medical Journal of AustraliaDeterminants of consultation length in Australian general practice
93 Citations2005Helena Britt, Lisa Valenti +1 more
To measure the independent effect on length of general‐practice consultations of a range of characteristics of the general practitioner, practice, patient and consultation, as a basis for considering future GP workforce needs.
Family PracticeCommunication in general practice: differences between European countries
89 Citations2003A. van den Brink-Muinen, PFM Verhaak +10 more
The study showed that GPs' gatekeeping role (with registered patients) was less important for doctor-patient communication than was expected and patient characteristics such as gender, age, having psychosocial problems, and familiarity between the doctor and the patient were the most important in explaining differences in communication.
Family PracticePatient-centredness: Is It Applicable Outside the West? Its Measurement and Effect on Outcomes
85 Citations1992Ronald J. Henbest, G S Fehrsen
The method for measuring patient-centredness was found to be valid, reliable, sensitive, and practical, being inexpensive, time efficient, suitable for consultations involving interpreters, and not requiring transcripts.
Patient Education and CounselingPhysician communication in different phases of a consultation at an oncology outpatient clinic related to patient satisfaction
72 Citations2003Hilde Eide, Peter Kjær Graugaard +2 more
The study suggests that the physician should not initiate discussion of psychosocial topics during physical exam, and there was a positive correlation between physician informal talk (IT) and patient satisfaction in the history-taking phase.
PubMedTraining residents in problem-solving treatment of depression: a pilot feasibility and impact study.
72 Citations2004Mark T. Hegel, Allen J. Dietrich +2 more
The PST-PC training program evaluated in this study is feasible in residency training and appears to influence practice post residency and warrant continued investigation of this training program with a larger sample of residents and evaluation of outcomes with depressed patients treated with PST- PC in real-world practice settings.
Archives of Internal MedicinePhysicians' Assessment of Functional Health Status and Well-being
64 Citations1995Edward L. Schor
A cross-sectional, national population survey of adults was conducted to obtain estimates of the frequency with which physicians reportedly inquire about patients' functional health status and emotional well-being, patients' attitudes about such assessments, and the perceived use of data thus obtained in the therapeutic process.
Journal of General Internal MedicineInterpersonal Skill in Medicine: The Essential Partner of Verbal Communication
63 Citations2007Lawrence Dyche
This paper offers a framework for describing interpersonal skills and understanding their relationship to verbal communication and describes an interpersonal skill-set comprised of Understanding, Empathy, and Relational Versatility.
BMJEmpathy is important for enablement
58 Citations2001Stewart W Mercer, Graham C M Watt +1 more
The pilot work that was done on the impact of homoeopathic consultations on patient enablement collected 200 valid questionnaires from 230 consecutive outpatients attending the Glasgow Homoeopathic Hospital, an NHS facility that integrates complementary and orthodox approaches.
PubMedTime for care. Length of general practice consultations in Australia.
58 Citations2002Helena Britt, Lisa Valenti +1 more
The majority of GPs are not practising 'six minute medicine', and may assist cost projections of any changes to the Medicare Schedule, this study suggests.
American Journal of PsychiatryClinical Interview Skills and Identification of Emotional Disorders in Primary Care
57 Citations1998Manuel Girón, Purificación Manjón-Arce +3 more
The findings of this research highlight the need to train primary care physicians in specific interview skills, in order to improve their ability to identify mental disorders in their practices.
Patient Education and CounselingWrapping things up: A qualitative analysis of the closing moments of the medical visit
55 Citations1997Jocelyn White, C. Parr Rosson +3 more
An operational definition of the closure phase of the medical visit is developed based on audiotaped data from 22 office visits to physicians and doctors' communication skills for closure are proposed.
PubMedSequenced questioning to elicit the patient's perspective on illness: effects on information disclosure, patient satisfaction, and time expenditure.
45 Citations2002Forrest Lang, Michael Floyd +2 more
Use of sequenced questions to elicit the PPI results in significant sharing of new information and increased patient satisfaction and requires only a modest investment of time.
PubMedA CRASH-COURSE IN CULTURAL COMPETENCE
43 Citations2006George Rust, Kofi Kondwani +9 more
The authors blended their extensive literature review with the knowledge and experience of a culturally diverse medical team to develop the CRASH-Course in Cultural Competency training program for medical professionals.
Family PracticeOn the relationship between the efficiency and the quality of the consultation. A validity study
42 Citations2001Jo Goedhuys, Jan‐Joost Rethans
Short consultations with high technical medical efficiency seem to be related to bad communication and dissatisfied patients, thus questioning the validity of the 'efficiency-per-time score' as a measure of competence.
Annals of Internal Medicine“What Else?” Setting the Agenda for the Clinical Interview
42 Citations2005Laurence H. Baker, Daniel O’Connell +1 more
Although clinicians tend to blame the patient for this distressing syndrome, in fact it is frequently the result of defective interview technique: failure to elicit the patient's entire agenda early in the visit.
PubMedRoutine, ceremony, or drama: an exploratory field study of the primary care clinical encounter.
42 Citations1992Miller Wl
Identifying a clinical encounter as a routine, ceremony, or drama may help family physicians integrate family systems concepts into their busy office practices.
PubMedResearch guidelines for assessing the impact of healing relationships in clinical medicine.
41 Citations2003William L. Miller, Benjamin F. Crabtree +3 more
A double-helix trial design is introduced, in which one strand consists of a standard quantitative approach and the other consists of qualitative methods, and the 2 strands are bonded by the questions addressed and by the participants in the study.
PubMedFamily interviewing: a review of the literature in primary care.
40 Citations2002Thomas L. Campbell, Susan H. McDaniel +3 more
Physicians use a wide range of family interviewing approaches with individual patients, with family members who accompany patients to office visits, and in family conferences.
BMJConsultation length: general practitioners' attitudes and practices.
29 Citations1985Andrew Wilson
Reported consultation length was associated with the doctor's gender, use of an appointment system, membership of the Royal College of General Practitioners, and the number of patients seen during an average surgery.
The Medical Journal of AustraliaConsultation length and chronic illness care in general practice: a qualitative study
29 Citations1999Carmel M. Martin, Cathy Banwell +2 more
To study the relationship between duration and content of general practice consultations for patients with chronic conditions, a large number of patients with Chronic conditions are referred to general practice clinics.
Mayo Clinic ProceedingsPatient-Physician Agreement About Medical Diagnoses and Cardiovascular Risk Factors in the Ambulatory General Medical Examination
25 Citations1996Sidna M. Scheitel, Benoit J. Boland +2 more
Because patients failed to report more than half of their most important health problems identified by their physicians, practitioners might consider giving problem lists or summary letters to patients to improve and reinforce communication and management of health problems.
Medical Entomology and ZoologyCurrent Thinking and Research in Brief Therapy: Solutions, Strategies, Narratives
24 Citations2013William J. Matthews, John Edgette
The state of the altered state debate, Kirsch hypnosis in the treatement of AIDS, Reed rehabilitation of chronic pain patients - expanding an Ericksonian approach to interdisciplinary team treatment, Feldman teaching children with asthma to help themselves with relaxation/mental imagery.
Family PracticeDoctors' Interviewing Technique and Its Response to Different Booking Time
23 Citations1992Leone Ridsdale, Myfanwy Morgan +1 more
The Annals of Family MedicineOpening the Black Box: Cognitive Strategies in Family Practice
18 Citations2005Robert E. Christensen
Family physicians have specific, highly individualized cognitive task-structuring approaches and show the decision behavior features typical of expert decision makers in other fields, which places constraints on and suggests useful approaches for improving practice.
Journal of General Internal MedicineDecision or No Decision: How Do Patient–Physician Interactions End and What Matters?
13 Citations2007Ming Tai‐Seale, Rachel Bramson +1 more
Although discussions often ended with explicit decisions, there were variations related to the content and dynamics of interactions that recommend strengthening patients’ voice and developing clinical tools to improving decision making.
…