The physician-patient working alliance: Theory,research, and future possibilities |
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| Affiliation: | 1. Derner Institute of Advanced Psychological Studies, Adelphi University, Garden City, NY 11530, USA;2. University of Missouri, Kansas City, MO, USA;1. Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT;2. Department of Rehabilitation Medicine, University of Washington, Seattle, WA;3. Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA;1. Behavioural Sciences & Health Research Division, University Health Network, Toronto, Ontario, Canada;2. College of Nursing, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada;3. School of Health, University of Central Lancashire, Preston, UK;1. NIVEL Netherlands Institute of Health Services Research, PO Box 1568, 3500 BN Utrecht, The Netherlands;2. Erasmus Medical Center, Department of General Practice, PO Box 2040, 3000 CA Rotterdam, The Netherlands;3. University Medical Center Utrecht, Department of Rehabilitation, Nursing Sciences and Sport, PO Box 85500, 3508 GA Utrecht, The Netherlands;1. University of Leicester, United Kingdom;2. The Open University, United Kingdom;3. University of Surrey, United Kingdom;1. The Alphington Sports Medicine Clinic, 339 Heidelberg Road, Northcote, Victoria, 3070, Australia;2. La Trobe University Sport and Exercise Medicine Research Centre, La Trobe University, Corner of Plenty Road and Kingsbury Drive, Bundoora, Victoria, 3083, Australia;3. MP Sports Physicians, Frankston Clinic, Suite 1, 20 Clarendon Street, Frankston, Victoria, 3199, Australia;1. Faculty of Medicine, Universidad San Pablo CEU, Spain;2. Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain;3. Motion in Brains Research Group, Institut of Neuroscience and Sciences of Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain;4. Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain |
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| Abstract: | ObjectiveThis article discusses the physician-patient working alliance and reviews the empirical research that has been generated on the working alliance to date.MethodsThe paper presents a brief history of the study of the physician-patient relationship, and discusses constructs that have examined aspects of the relationship, such as empathy, trust, and shared decision-making. Lastly, a meta-analysis was conducted based on the seven empirical studies (a total N of 1023 patients) that have examined the physician-patient working alliance.ResultsResults of the meta-analysis found medium to large effect sizes between the working alliance and various behavioral care indices. The working alliance is positively associated with patient adherence, satisfaction, and improved patient outcomes.ConclusionOverall, the physician-patient working alliance provides researchers and medical-care providers with a unified construct that combines cognitive and affective dimensions inherent in the relationship in medical care. Furthermore, the PPWAI provides an efficient and inexpensive way to assess the physician-patient relationship in medical treatment.Practice implicationsThe present findings warrant the development of an intervention focused on working alliance training that could be offered to healthcare providers. |
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| Keywords: | Physician-patient working alliance |
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