Long-Term Doctor-Patient Relationships: Patient Perspective From Online Reviews

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Abstract

Background

Continuity of patient care is one of the cornerstones of primary care.

Objective

To examine publicly available, Internet-based reviews of adult primary care physicians, specifically written by patients who report long-term relationships with their physicians.

Methods

This substudy was nested within a larger qualitative content analysis of online physician ratings. We focused on reviews reflecting an established patient-physician relationship, that is, those seeing their physicians for at least 1 year.

Results

Of the 712 Internet reviews of primary care physicians, 93 reviews (13.1%) were from patients that self-identified as having a long-term relationship with their physician, 11 reviews (1.5%) commented on a first-time visit to a physician, and the remainder of reviews (85.4%) did not specify the amount of time with their physician. Analysis revealed six overarching domains: (1) personality traits or descriptors of the physician, (2) technical competence, (3) communication, (4) access to physician, (5) office staff/environment, and (6) coordination of care.

Conclusions

Our analysis shows that patients who have been with their physician for at least 1 year write positive reviews on public websites and focus on physician attributes.

Related collections

Most cited references 40

Record: found
Abstract: not found
Book: not found

To Err Is Human : Building a Safer Health System

(2000)

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Record: found
Abstract: found
Article: not found

Observational study of effect of patient centredness and positive approach on outcomes of general practice consultations.

Jonathan Little, Gina C. Gould, Brook G. Warner … (2001)

To measure patients' perceptions of patient centredness and the relation of these perceptions to outcomes. Observational study using questionnaires. Three general practices. 865 consecutive patients attending the practices. Patients' enablement, satisfaction, and burden of symptoms. Factor analysis identified five components. These were communication and partnership (a sympathetic doctor interested in patients' worries and expectations and who discusses and agrees the problem and treatment, Cronbach's alpha=0.96); personal relationship (a doctor who knows the patient and their emotional needs, alpha=0.89); health promotion (alpha=0.87); positive approach (being definite about the problem and when it would settle, alpha=0.84); and interest in effect on patient's life (alpha=0.89). Satisfaction was related to communication and partnership (adjusted beta=19.1; 95% confidence interval 17.7 to 20.7) and a positive approach (4.28; 2.96 to 5.60). Enablement was greater with interest in the effect on life (0.55; 0.25 to 0.86), health promotion (0.57; 0.30 to 0.85), and a positive approach (0.82; 0.52 to 1.11). A positive approach was also associated with reduced symptom burden at one month (beta=-0.25; -0.41 to -0.10). Referrals were fewer if patients felt they had a personal relationship with their doctor (odds ratio 0.70; 0.54 to 0.90). Components of patients' perceptions can be measured reliably and predict different outcomes. If doctors don't provide a positive, patient centred approach patients will be less satisfied, less enabled, and may have greater symptom burden and higher rates of referral.

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Physician-patient communication in the primary care office: a systematic review.

Rainer Beck, Rebecca Daughtridge, Philip Sloane (2015)

The physician-patient interview is the key component of all health care, particularly of primary medical care. This review sought to evaluate existing primary-care-based research studies to determine which verbal and nonverbal behaviors on the part of the physician during the medical encounter have been linked in empirical studies with favorable patient outcomes. We reviewed the literature from 1975 to 2000 for studies of office interactions between primary care physicians and patients that evaluated these interactions empirically using neutral observers who coded observed encounters, videotapes, or audiotapes. Each study was reviewed for the quality of the methods and to find statistically significant relations between specific physician behaviors and patient outcomes. In examining nonverbal behaviors, because of a paucity of clinical outcome studies, outcomes were expanded to include associations with patient characteristics or subjective ratings of the interaction by observers. We found 14 studies of verbal communication and 8 studies of nonverbal communication that met inclusion criteria. Verbal behaviors positively associated with health outcomes included empathy, reassurance and support, various patient-centered questioning techniques, encounter length, history taking, explanations, both dominant and passive physician styles, positive reinforcement, humor, psychosocial talk, time in health education and information sharing, friendliness, courtesy, orienting the patient during examination, and summarization and clarification. Nonverbal behaviors positively associated with outcomes included head nodding, forward lean, direct body orientation, uncrossed legs and arms, arm symmetry, and less mutual gaze. Existing research is limited because of lack of consensus of what to measure, conflicting findings, and relative lack of empirical studies (especially of nonverbal behavior). Nonetheless, medical educators should focus on teaching and reinforcing behaviors known to be facilitative, and to continue to understand further how physician behavior can enhance favorable patient outcomes, such as understanding and adherence to medical regimens and overall satisfaction.

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Author and article information

Contributors

Urmimala Sarkar:

Center for Vulnerable PopulationsDivision of General Internal MedicineUniversity of California, San Francisco1001 Potrero AveBldg 10, FL 3, Ward 13San Francisco, CA, 94110United States1 415 206 69621 415 206 5586usarkar@medsfgh.ucsf.edu

Journal

Journal ID (nlm-ta): J Med Internet Res

Journal ID (publisher-id): JMIR

Title: Journal of Medical Internet Research

Publisher: JMIR Publications Inc. (Toronto, Canada )

ISSN (Print): 1439-4456

ISSN (Electronic): 1438-8871

Publication date Collection: July 2013

Publication date (Electronic): 02 July 2013

Volume: 15

Issue: 7

Electronic Location Identifier: e131

Affiliations

[1] ¹UCLA Division of General Internal Medicine and Health Services Research University of California, Los Angeles Los Angeles, CAUnited States

[2] ²Center for Vulnerable Populations Division of General Internal Medicine University of California, San Francisco San Francisco, CAUnited States

Author notes

Corresponding Author: Urmimala Sarkar usarkar@ 123456medsfgh.ucsf.edu

Article

Publisher ID: v15i7e131

DOI: 10.2196/jmir.2552

PMC ID: 3713916

PubMed ID: 23819959

SO-VID: 5835b39b-a29e-4320-83d3-87ca9b88b562

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 28 January 2013

Date revision requested : 26 March 2013

Date revision received : 10 April 2013

Date accepted : 24 April 2013

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