The impact of patient-centered communication on patients' decision making and evaluations of physicians: a randomized study using video vignettes

Objective

To assess the impact of patient-centered communication (PCC) behaviors on patients’ evaluations of physicians and acceptance of clinical recommendations.

Methods

We randomized 248 patients to view video-recorded, standardized vignettes, depicting a cardiologist using a high vs. low degree of PCC while recommending bypass surgery to a patient with angina and 3-vessel coronary artery disease. We compared patients’ ratings of the physician and their decision making in response to the physician's recommendation, for high vs. low PCC vignettes.

Results

Patients viewing high PCC vignettes rated the video physician more favorably overall (3.01 vs. 2.12, p < 0.001) and as more competent (3.22 vs. 2.66, p < 0.001) and trustworthy (2.93 vs. 2.28, p < 0.001) than those viewing the low PCC version (0-4 range for all scales). Patients viewing the high PCC version more frequently said they would undergo bypass surgery (96% vs. 74%, p < 0.001) if they were the patient in the video.

Conclusion

Patients expressed greater confidence in physicians who used more PCC behaviors, and greater willingness to accept an evidence-based recommendation.

Practice implications

PCC may make physicians more effective in the delivery of evidence-based care.