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The average physician conducts between 140,000 and 160,000 medical interviews in the lifetime of his or her practice, making it the most frequently used medical procedure. Strong evidence links interpersonal processes of care to a variety of positive outcomes. For example, in studies done by faculty at Johns Hopkins and elsewhere, patients who report greater involvement in medical care are more satisfied with their physicians, report more understanding, reassurance and perceived control over their illness, and have improvements in medical conditions. Patients who explicitly report being treated with respect and dignity have higher trust, are more adherent to care and are more likely to receive optimal preventive care.
Studies that have directly observed patient-physician communication have demonstrated a positive effect of physician communication behaviors on patient outcomes including pain relief, satisfaction, compliance, and recall of information. In their interactions with African-American patients, physicians have been shown to exhibit less nonverbal attention, empathy, courtesy, and information giving, to adopt a more “narrowly biomedical” communication style, to spend less time providing health education, chatting and answering questions, and to be more verbally dominant and exhibit more negative emotional tone than with white patients. Finally, studies have found that physicians offer more information and have a more positive affect with patients for whom they report having a great deal of respect, that patients are fairly well able to judge whether or not their physician has respect for them.
Faculty in Hopkins GIM have interests and expertise in examining a variety of the interpersonal aspects of health care delivery. Faculty use standard methods such as direct observation of patient-provider encounters using audiotaped analysis and patient experience of care using patient ratings, and have forged novel areas such as the impact of race/ethnicity on the patient-provider relationship and the impact of healthcare providers’ attitudes on patient experiences and outcomes.