Clinical Pediatrics

 

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First published on September 27, 2007, doi:10.1177/0009922807305650

Clinical Pediatrics 2008;47:49.

A more recent version of this article appeared on February 1, 2008


Article

The Clinician-Patient Partnership Paradigm: Outcomes Associated With Physician Communication Behavior

Noreen M. Clark, PhD1*, Michael D. Cabana, MD, MPH2, Bin Nan, PhD3, Z. Molly Gong, MD3, Kathryn K. Slish, MA3, Nancy A. Birk, MA4, and Niko Kaciroti, PhD1

1 University of Michigan
2 University of California
3 University of Michigan School of Public Health
4 University of Michigan School of Education

* To whom correspondence should be addressed. E-mail: nmclark{at}umich.edu.


   Abstract
Objective To identify physician communication behaviors associated with perceptions of quality of care and predictive of positive patient outcomes. Patients and Methods A total of 452 families seeing 48 pediatricians for a child’s asthma participated. Perceptions and health care use were assessed at baseline and after 12 months through interviews and medical records. The measures used were 10 physician communication behaviors and 6 items describing physician’s performance, asthma office visits, emergency department visits, and hospitalization. Results Positive perceptions of physicians’ performance were related to (P ≤ .05) careful listening, inquiring about at-home management, nonverbal attention, interactive conversation, tailoring short-term goals, and long-term therapeutic plan. Loss in health care use was predicted (P≤ .05) by interactive conversation, short-term goals, criteria for decision making, long-term treatment plan, and tailoring according to needs. The use of these techniques did not lengthen the patient visit. A clinician-patient partnership paradigm is provided based on these findings. Conclusions The specific clinician communication behaviors predicted reduced health care use and positive perceptions of quality of care.
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