Testing the Value of Patient-reported Physician Quality Information for Quality Improvement and Consumer Choice
Grant Description and Policy Summary: Physicians and medical educators have repeatedly acknowledged that the art of effective communication skills with patients is not widely taught in medical schools or continuing medical education courses for physicians. To test the extent to which it is possible to improve a physician’s communication skills, the researchers conducted a controlled intervention designed to improve the quality of physician-patient relationships. The intervention group consisted of 10 Californian physicians who scored at or below the state 25th percentile of performance on a quality of physician-patient interaction measure. The control group included 11 physicians who also scored below the 25th percentile of performance. The intervention group participated in a workshop and two group teleconferences on communicating with patients. Physicians in the intervention group were taught to use an “agenda-setting” technique to initiate the patient encounter and gather information in order to prioritize health issues for visits. To assess the effectiveness of the intervention, the researchers conducted one pre-intervention survey and two post-intervention surveys of patients. Patient experience scores on the survey were compared between the intervention and the control groups. There was statistically significant improvement in intervention physicians’ ability to “explain things in a way that was easy to understand” and marginally significant improvement in the overall quality of physician-patient interactions compared to control group physicians. However, there were no significant differences in scores related to organizational access, care coordination, or office staff interactions. The results indicate that a simple and modest intervention (such as a workshop and two follow-up teleconferences) with physicians on communication techniques can have a positive impact on patients’ experiences with care. Practicing physicians who lack communication skills may end up adding time, cost, and discontent to the overall clinical encounter with patients. There is also evidence suggesting that poor communication by the physician with patients can lead to malpractice claims. As health care in this country is becoming more patient-centered, it is logical to create techniques which support a patient-centered clinical encounter. The study suggests that it is possible to modify physicians’ communication habits. If an effort is made to improve physicians’ ability to communicate with patients, patients may be more likely to have enhanced clinical encounters.