Healthcare Quality:
(The impact of communication between physician and patient on the outpatient
service)
Good communication between a physician and a patient is necessary for the
former to understand and appropriately treat a problem that brings the latter to the
hospital. The physician-patient communication includes information exchanging,
assisting patients in self-management of their conditions, managing uncertainty and
emotions, making decisions, and improving the physician-patient relationship.
Moreover, adequate physician-patient communication has been linked to positive
health outcomes. The purpose of this research is to explain the impact of
communication between physician and patient on the outpatient service and
healthcare quality in general.
Literature Review
A literature search was carried out using two separate databases: PubMed and
Google Scholar. The key terms ‘quality impact’ or ‘outcome’ were explored together
with ‘physician and patient communication’ or ‘outpatient communication.’ After
collecting all the relevant publications, every book/article was read thoroughly to
obtain its contents. The main ideas are presented below.
Effective communication between a doctor and a patient can assist in
improving the latter’ emotions, understanding of medical information, and getting
information on patients’ requirements, perceptions, and expectations. Patients who
consider their communication with physicians as effective are more likely to be
contented with their outpatient visits, willingly share relevant information for proper
diagnosis of their conditions, and adhere to advice and treatment (Arora, 2003;
Stewart, 1995). The concurrence of patients and physicians about the type of
treatment and the need for follow-up is closely associated with the recovery process
(Stewart, Brown, & Donner, 2000). Moreover, productive communication has been
shown to have a strong connection with a sense of control and ability to tolerate pain
among patients suffering from chronic conditions. Patients having good
communication with their doctors also exhibited psychological adjustment and better
mental health. Little et al. (2001) found that effective communication between
physicians and patients also leads to lower cost of individual medical visits and fewer
referrals.
Various studies also link physician-patient communication to adherence levels
among patients. Zolnierek and DiMatteo (2009) carried a meta-analysis on physicianpatient communication and found that there is a strong correlation with patient
adherence. A Health Care Quality Survey conducted by the Commonwealth Fund
established that 25% of Americans did not adhere to their physicians’
recommendations (Davis et al., 2002). The survey found that 39% differed with the
recommendations of a medical practitioner, 27% could not adhere because of the cost,
20% stated that the recommendation was against their personal beliefs, while 7%
asserted that they did not comprehend the instructions. Effective physician-patient
communication would eliminate such high levels of non-adherence to the instructions.
It was also concluded that there were increases in adherence when doctors obtained
communication training.
Discussion
Various studies have focused on the influence of physician-patient
communication on health outcomes in inpatient services. However, this paper sought
to find the impact of communication between physician and patients on the outpatient
services. It hypothesizes that physician-patient communication leads to higher
adherence levels, more patient satisfaction, better physical and mental health, seeking
of preventive services, and more satisfied physicians.
Adherence
Adherence refers to the degree to which a patient’s behavior matches with the
recommendations from a doctor. Excellent physician-patient communication will lead
to higher adherence levels in the outpatient service. This is because good physician
and patient communication results in a patient assuming a more active and
participatory role in decision-making because he or she trusts a doctor. The two
reasons increase the patient ability to adhere to the physicians’ recommendations in
outpatient care settings. Negative patient attitudes towards physicians are highly
linked to non-adherence, although the existence of side effects from the medications
or their costs also adds to the problem. Conversely, better communication results in
improved understanding by the patient of the condition processes that require
treatment, the intended goals of the treatment, potential side effects, and how and
when the treatment should be undertaken. The cost of medication also affects
adherence.
Better Health, Functional, and Emotional Status
Effective physician-patient communication has a positive effect on the health,
functional, and emotional status of the patient. Roter et al. (1997) carried a study that
examined the effects of communication skills training on the process and result of
patient care; it found that effective communication lead to decreased emotional
distress in patients. On the other hand, Stewart et al. (1995) conducted a review of
twenty-one studies that examined the effects of physician-patient communication on
patient health results and found that the quality of communication and dialogue on the
management plan result in an improved health outcome. They also revealed that
effective communication is linked to the better management of chronic conditions
such as blood pressure and pain control. Therefore, there will be better health,
functional, and emotional status of patients in outpatient services when there is a good
physician-patient communication.
Enhanced Physician Satisfaction
Good communication between doctors and patients is also associated with
improved physician satisfaction with their professional life. It is because the satisfied
physicians feel that they can attend to the concern of the patients. Grembowski et al.
(2005) conducted a study in the outpatient department of a teaching hospital and
found that physicians’ satisfaction with their professional life was linked to patients’
high trust and confidence in their primary care physicians. It shows that satisfied
physicians are happier that they can deal with the concerns of patients. Such happy
doctors may also have better communication with patients, which in turn improves the
satisfaction levels of patients. Interestingly, patients cite physician satisfaction as one
of the main factors of visiting a particular hospital (Victoor, Delnoij, Friele, &
Rademakers, 2012). Therefore, good communication between doctors and patients
will result in the formers’ satisfaction in the outpatient service.
Improved Use of Preventive Medical Services
Good physician-patient connection results in better use of preventive medical
services; for instance, patients will be more willing to use cancer screening.
Preventing care leads to better health and lower costs. Therefore, there will be more
use of preventive medical services in the outpatient service when there is good
communication between a physician and a patient.
Physical Health
Physical health status includes pain and other symptoms, disease markers,
functional capacity, and subjective self-ratings of health. Outpatient treatment leads to
better physical health includes medication and behavioral regimens such as smoking
cessation and diet. For instance, a patient may experience better physical health
because he or she obtained medication that controlled the disease, adopted healthier
exercises, and believed the treatment was effective, which will be the result of the
followed doctor’s prescriptions. Therefore, the communication can result in better
health if the communication between a physician and a patient helped to identify the
correct diagnosis and suitable treatment plan.
References
Arora, N. K. (2003). Interacting with cancer patients: The significance of physicians’
communication behavior. Social Science &Medicine, 57(5), 791-806.
Davis, K., Schoenbaum, S. C., Collins, K. S., Tenney, K., Hughes, D. L., & Audet, A.
M. J. (2002). Room for improvement: Patients report on the quality of their
health care. Washington, DC: The Commonwealth Fund. Retrieved from
http://www.commonwealthfund.org/usr_doc/davis_improvement_534.pdf
Grembowski, D., Paschane, D., Diehr, P., Katon, W., Martin, D., & Patrick, D. L.
(2005). Managed care, physician job satisfaction, and the quality of primary
care. Journal of General Internal Medicine, 20(3), 271-277.
Little, P., Everitt, H., Williamson, I., Warner, G., Moore, M., Gould, C., … & Payne,
S. (2001). Observational study of effect of patient centredness and positive
approach on outcomes of general practice consultations. Bmj, 323(7318), 908-911.
Roter, D. L., Steward, M., Putnam, S. M., Lipkin, M., Jr., Stitles, W., & Inui, T. S.
(1997). Communication patterns of primary care physicians. Journal of the
American Medical Association, 277(4), 350-356.
Stewart, M. A. (1995). Effective physician-patient communication and health
outcomes: A review. Canadian Medical Association Journal, 152(9), 1423-1433.
Stewart, M., Brown J. B., Donner A., McWhinney, I. R., Oates, J., Weston, W. W., &
Jordan, J. (2000). The impact of patient-centered care on outcomes. Journal of
Family Practice, 49(9), 796–804
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