Patients’ encounters with physicians are at the center of their health care. The way in which physicians communicate with patients can affect patients’ understanding of their health condition, health status, and quality of care. Patient-centered communication and shared decision-making are ethically the right things to do.
Systematic reviews of the preconditions for improving healthcare delivery have emphasized the importance of patient-physician communication as a mediator and moderator of health care quality. It has been well documented, however, that patients often hesitate in being completely open about their concerns and preferences during clinical encounters out of fear of being labeled “difficult’. In addition, even when patients do ask questions, physicians’ answers vary in quality. When patients are activated to ask questions and be more engaged in their visits, some are met with discouraging or dismissive reactions from unprepared clinicians.
The Learning Health Systems Center of Excellence has worked with two research studies aimed at improving patient-centered communication:
Improving Patient-Centered Communication in Primary Care: A Cluster Randomized Controlled Trial of the Comparative Effectiveness of Three Interventions
A cluster randomized controlled trial evaluating three strategies for enhancing patient-centered communication. The goal of the study is to engage patients and physicians to incorporate patient-centered communication in their encounters.
Creating a Zone of Openness to Increase Patient-Centered Care
A pilot study to design a novel intervention with patient and healthcare team stakeholders that targeted both patients and providers to enhance patient–provider communication. The pilot study was a cluster randomized controlled trial of the new intervention comparing it to an existing patient intervention to obtain data to guide the design of a large-scale comparative effectiveness study.