How patients want their doctor to communicate. A literature review on primary care patients' perspective.

OBJECTIVE To review the literature on the communicative behaviours primary care patients want from a "good" physician. METHODS An electronic search used the key words doctor-patient relation AND patient desires OR patient expectations OR patient preferences (from now on referred to as expectations). The qualitative and quantitative articles meeting the selection criteria were analysed separately, comparing methods, definitions, measures and outcomes. The physician behaviours desirable from a patient perspective were grouped by linking them to the communicative functions of an effective medical encounter as defined from a professional perspective. RESULTS Twenty-seven studies were included. Critical issues were the heterogeneity of definitions and measures and the lack of integration between quantitative and qualitative findings. Most of the expectations in qualitative studies were related to the function "Fostering the relationship". Similar expectations arose less often in quantitative studies. CONCLUSIONS Patients do have concrete expectations regarding each of the functions to be met in the medical encounters. The research approach tends to bias the results. PRACTICE IMPLICATIONS The collected expectations suggest how physicians may perform each of their tasks according to the patient perspective. Future research on patients' communicative expectations needs to overcome the gap between qualitative and quantitative findings.

[1]  T. Saleem,et al.  Geriatric patients' expectations of their physicians: findings from a tertiary care hospital in Pakistan , 2009, BMC health services research.

[2]  M. Moore What does patient‐centred communication mean in Nepal? , 2007, Medical education.

[3]  W. Carter,et al.  Patient requests and expectations. Definitions and clinical applications. , 1984, Medical care.

[4]  R. Teas,et al.  Expectations, Performance Evaluation, and Consumers’ Perceptions of Quality , 1993 .

[5]  J. Bensing,et al.  Doctor-patient communication in different European health care systems: relevance and performance from the patients' perspective. , 2000, Patient education and counseling.

[6]  G. L. Engel The need for a new medical model: a challenge for biomedicine. , 2012, Psychodynamic psychiatry.

[7]  A. Delgado,et al.  Patient expectations are not always the same , 2008, Journal of Epidemiology & Community Health.

[8]  J. Bensing,et al.  Afghan refugees and their general practitioners in The Netherlands: to trust or not to trust? , 2007, Sociology of health & illness.

[9]  C. Cedraschi,et al.  How do patients define "good" and "bad" doctors? , 2005, Swiss medical weekly.

[10]  B. Young,et al.  Core assumptions and research opportunities in clinical communication. , 2005, Patient education and counseling.

[11]  G. Rowe,et al.  A study of patient expectations in a Norfolk general practice , 2010, Health expectations : an international journal of public participation in health care and health policy.

[12]  T. Bodenheimer,et al.  Patient self-management of chronic disease in primary care. , 2002, JAMA.

[13]  S. Rollnick,et al.  The practitioner, the patient and resistance to change: recent ideas on compliance. , 1996, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[14]  Heather-Lyn Haley,et al.  How patients perceive a doctor's caring attitude. , 2008, Patient education and counseling.

[15]  S. Payne,et al.  Preferences of patients for patient centred approach to consultation in primary care: observational study , 2001, BMJ : British Medical Journal.

[16]  R. Ruiz-Moral,et al.  The Effect of Patients’ Met Expectations on Consultation Outcomes. A Study with Family Medicine Residents , 2007, Journal of General Internal Medicine.

[17]  L. Noble,et al.  The effect of professional skills training on patient‐centredness and confidence in communicating with patients , 2007, Medical education.

[18]  D. Hickam,et al.  Patients' desires and satisfaction in general medicine clinics. , 1993, Public health reports.

[19]  K. Malterud,et al.  The purpose of the general practice consultation from the patient's perspective--theoretical aspects. , 2001, Family practice.

[20]  R. Säljö,et al.  Reasons for adherence with antihypertensive medication. , 2000, International journal of cardiology.

[21]  R. Bull,et al.  The development of a scale to discover outpatients' perceptions of the relative desirability of different elements of doctors' communication behaviours. , 2006, Patient education and counseling.

[22]  R. Kravitz Patients' Expectations for Medical Care: An Expanded Formulation Based on Review of the Literature , 1996, Medical care research and review : MCRR.

[23]  T. Peters,et al.  The patient-centredness of consultations and outcome in primary care. , 1999, The British journal of general practice : the journal of the Royal College of General Practitioners.

[24]  Susan Slaughter,et al.  What is a health expectation? Developing a pragmatic conceptual model from psychological theory , 2006, Health expectations : an international journal of public participation in health care and health policy.

[25]  Maureen A. Smith,et al.  The Medical Interview: The Three-Function Approach , 1991, The Yale Journal of Biology and Medicine.

[26]  D. Healy,et al.  The meaning of patient satisfaction: an explanation of high reported levels. , 1998, Social science & medicine.

[27]  O. Baron-Epel,et al.  Evaluation of the consumer model: relationship between patients' expectations, perceptions and satisfaction with care. , 2001, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[28]  A. Schattner,et al.  Good physicians from the perspective of their patients , 2004, BMC health services research.

[29]  L B Bourque,et al.  A randomized controlled trial of facilitating information giving to patients with chronic medical conditions: effects on outcomes of care. , 1999, The Journal of family practice.

[30]  JN Vieder,et al.  Physician-patient interaction: what do elders want? , 2002, The Journal of the American Osteopathic Association.

[31]  H. Dale,et al.  What Young African American Women Want in a Health Care Provider , 2010, Qualitative health research.

[32]  Nancy R. Katz,et al.  Relations Between Physicians' Behaviors and Analogue Patients' Satisfaction, Recall, and Impressions , 1987, Medical care.

[33]  J. Bensing,et al.  Teaching clinically experienced physicians communication skills. A review of evaluation studies , 1999, Medical education.

[34]  J Bird,et al.  The three-function model of the medical interview. An educational device. , 1990, Advances in psychosomatic medicine.

[35]  F Olesen,et al.  A systematic review of the literature on patient priorities for general practice care. Part 1: Description of the research domain. , 1998, Social science & medicine.

[36]  A. Coulter,et al.  What do patients want from high-quality general practice and how do we involve them in improvement? , 2002, The British journal of general practice : the journal of the Royal College of General Practitioners.

[37]  M. Stewart Towards a global definition of patient centred care , 2001, BMJ : British Medical Journal.

[38]  K. Baum,et al.  What women want from their physicians: a qualitative analysis. , 2007, Journal of women's health.

[39]  H. Maaroos,et al.  Patient expectations from consultation with family physician. , 2006, Croatian medical journal.

[40]  P. Bower,et al.  What Patients Want From Primary Care Consultations: A Discrete Choice Experiment to Identify Patients’ Priorities , 2008, The Annals of Family Medicine.

[41]  R. Grol,et al.  Patient characteristics as predictors of primary health care preferences: a systematic literature analysis , 2003, Health expectations : an international journal of public participation in health care and health policy.

[42]  Judith A. Hall,et al.  Meta-analysis of Correlates of Provider Behavior in Medical Encounters , 1988, Medical care.

[43]  J. Dale,et al.  Patient expectations: what do primary care patients want from the GP and how far does meeting expectations affect patient satisfaction? , 1995, Family practice.

[44]  F. Oort,et al.  Coding patient-centred behaviour in the medical encounter. , 2005, Social science & medicine.

[45]  I. Svab,et al.  Meeting patient's expectations in primary care consultations in Lithuania. , 2004, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[46]  J. de Haes,et al.  Doctor-patient communication: a review of the literature. , 1995, Social science & medicine.

[47]  Miguel P Caldas,et al.  Research design: qualitative, quantitative, and mixed methods approaches , 2003 .

[48]  M. Woloshynowych,et al.  The Patient Requests Form: a way of measuring what patients want from their general practitioner. , 1996, Journal of psychosomatic research.

[49]  D. K. Raynor,et al.  Ask the patients—they may want to know more than you think , 2003, BMJ : British Medical Journal.

[50]  J. Bensing,et al.  Do our talks with patients meet their expectations? , 2007, The Journal of family practice.

[51]  P. Vedsted,et al.  Association between patients’ recommendation of their GP and their evaluation of the GP , 2008, Scandinavian journal of primary health care.

[52]  Ernesto Mola,et al.  Integrating patient empowerment as an essential characteristic of the discipline of general practice/family medicine , 2008, The European journal of general practice.

[53]  B. Lo,et al.  'She gave it her best shot right away': patient experiences of biomedical and patient-centered communication. , 2006, Patient education and counseling.

[54]  R. McKinley,et al.  Original papers , 2011 .

[55]  J. Bensing,et al.  Endpoints in medical communication research, proposing a framework of functions and outcomes. , 2009, Patient education and counseling.

[56]  J. Nyce,et al.  Patients comment on video-recorded consultations — the “good” GP and the “bad” , 1992, Scandinavian journal of social medicine.

[57]  J. Ware,et al.  Linking primary care performance to outcomes of care. , 1998, The Journal of family practice.

[58]  D. Dickinson,et al.  What information do patients need about medicines? Ask the patients--they may want to know more than you think. , 2003, BMJ.