Physician-patient communication in managed care.

The quality of physician-patient communication affects important health care outcomes. Managed care presents a number of challenges to physician-patient communication, including shorter visits, decreased continuity, and lower levels of trust. Good communication skills can help physicians create and maintain healthy relationships with patients in the face of these challenges. We describe 5 communication dilemmas that are common in managed care and review possible solutions suggested by recent literature on physician-patient communication. We also describe ways that managed care plans can promote more effective communication between physicians and patients.

[1]  W. Levinson,et al.  Wrapping things up: a qualitative analysis of the closing moments of the medical visit. , 1997, Patient education and counseling.

[2]  Mack Lipkin,et al.  The Medical Interview: Clinical Care, Education, and Research , 2011 .

[3]  E. Emanuel,et al.  Preserving the physician-patient relationship in the era of managed care. , 1995, JAMA.

[4]  A. Lazare The Interview as a Clinical Negotiation , 1995 .

[5]  R. Epstein,et al.  Health care reform and patient-physician communication. , 1994, American family physician.

[6]  R. Frankel,et al.  Getting the most from a 20-minute visit. , 1994, American Journal of Gastroenterology.

[7]  C. Perry Conflicts of interest and the physician's duty to inform. , 1994, The American journal of medicine.

[8]  R. C. Hall Legal precedents affecting managed care. The physician's responsibilities to patients. , 1994, Psychosomatics.

[9]  W. Levinson,et al.  "Oh, by the way ...": the closing moments of the medical visit. , 1994, Journal of general internal medicine.

[10]  P. S. Mills,et al.  Managed Care and Cardiac Pacing and Electrophysiology , 1993, Pacing and clinical electrophysiology : PACE.

[11]  D. Drossman,et al.  Medical interviewing and interpersonal skills teaching in US medical schools. Progress, problems, and promise. , 1993, JAMA.

[12]  W. Branch,et al.  Using 'windows of opportunities' in brief interviews to understand patients' concerns. , 1993, JAMA.

[13]  Wendy Levinson,et al.  Physician Frustration in Communicating with Patients , 1993, Medical care.

[14]  T. C. Smith,et al.  The inherent, powerful therapeutic value of a good physician-patient relationship. , 1993, Psychosomatics.

[15]  L. Baker,et al.  Physician satisfaction under managed care. , 1993, Health affairs.

[16]  M. Baird,et al.  Levels of physician involvement with psychosocial concerns of individual patients: a developmental model. , 1993, Family medicine.

[17]  M. Greenlick,et al.  Educating physicians for population-based clinical practice. , 1992, JAMA.

[18]  W. Scheckler,et al.  Physician satisfaction in a managed care environment. , 1992, The Journal of family practice.

[19]  J. Prochaska,et al.  In Search of How People Change: Applications to Addictive Behaviors , 1992, The American psychologist.

[20]  M. Stewart,et al.  Doctor-patient communication: the Toronto consensus statement. , 1991, BMJ.

[21]  R C Smith,et al.  The patient's story: integrating the patient- and physician-centered approaches to interviewing. , 1991, Annals of internal medicine.

[22]  D. Simpson,et al.  A survey of sued and nonsued physicians and suing patients. , 1989, Archives of internal medicine.

[23]  T. Quill,et al.  Recognizing and adjusting to barriers in doctor-patient communication. , 1989, Annals of internal medicine.

[24]  L. Forrow,et al.  Physicians' attitudes toward using deception to resolve difficult ethical problems. , 1989, JAMA.

[25]  S. Kaplan,et al.  Assessing the Effects of Physician-Patient Interactions on the Outcomes of Chronic Disease , 1989, Medical care.

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

[27]  T. Coates,et al.  A clinician's guide to helping patients change behavior. , 1987, The Western journal of medicine.

[28]  J. Webster,et al.  Prepaid entitlements. A new challenge for physician-patient relationships. , 1985, JAMA.

[29]  R. Frankel,et al.  The effect of physician behavior on the collection of data. , 1984, Annals of internal medicine.

[30]  A. R. Martin,et al.  Exploring patient beliefs. Steps to enhancing physician-patient interaction. , 1983, Archives of Internal Medicine.

[31]  L. Goldman,et al.  Ten commandments for effective consultations. , 1983, Archives of internal medicine.

[32]  T. Quill,et al.  Partnerships in patient care: a contractual approach. , 1983, Annals of internal medicine.

[33]  J. Ware,et al.  Behavioral consequences of consumer dissatisfaction with medical care. , 1983, Evaluation and program planning.

[34]  A. Barsky,et al.  Hidden reasons some patients visit doctors. , 1981, Annals of internal medicine.