THE PATIENT–PRACTITIONER RELATIONSHIP

• PATIENT PREFERENCES FOR PARTICIPATION

IN MEDICAL CARE
- Patients have different preferences for the level of involvement and information they want
when seeking medical treatment
- Factors such as gender, age, and sociocultural differences influence patients' participation
preferences
- Meeting patients' participation preferences leads to enhanced adjustment to treatment and
greater satisfaction
- A mismatch between desired level of participation and what the practitioner provides can lead
to increased stress, noncompliance with advice, and dissatisfaction
- Practitioners need to assess and consider the level of involvement desired by each patient

THE PRACTITIONER’S BEHAVIOR AND STYLE

- Diagnosing and treating health problems can be difficult tasks
- Different physicians have different styles of interacting with patients
- Doctor-centered physicians focus mainly on the first problem mentioned and ignore attempts
by patients to discuss other problems
- Patient-centered physicians take less controlling roles, ask open-ended questions, and allow
patients to participate in decision making
- Female physicians tend to spend more time with patients and use a more patient-centered
style
- Physicians sometimes impede communication by using medical jargon or technical terms that
patients may not understand
- Patients prefer practitioners who are competent and show sensitivity, warmth, and concern
- The style of the practitioner can affect patient satisfaction and adherence to medical advice
- Medical schools are introducing programs to educate future physicians on interviewing skills
and psychosocial factors in treating patients

THE PATIENT’S BEHAVIOR AND STYLE

- The behavior and style of both the patient and practitioner are important in the
patient-practitioner relationship.
- Some patient behaviors can unsettle doctors, including not following prescribed treatment,
waiting too long with symptoms, insisting on unnecessary tests or procedures, making sexually
suggestive remarks, and requesting false certifications.
- Patients may give unclear descriptions of symptoms due to different interpretations, different
commonsense models of illness, attempts to downplay or emphasize symptoms, language
barriers, or lack of understanding.
- Communication between patients and practitioners can be improved through training programs
for practitioners, encouraging patients to fill out symptom and question forms, and teaching
practitioners to ask questions and summarize information.
- Practitioners also cannot be sure if patients are following their recommended treatment or
lifestyle changes.