Liking in the physician–patient relationship

Hall, Judith A.; Horgan, Terrence G.; Stein, Terry S.; Roter, Debra

doi:10.1016/s0738-3991(02)00071-x

Cited by 179 publications

(148 citation statements)

References 22 publications

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“…This finding is consistent with a growing body of evidence indicating that how a physician perceives a patient (likeable, intelligent, adherent) is related to how that doctor treats the patient (Amir, 1987;Beach, Roter, Wang, Duggan & Cooper, 2006a;Gerbert, 1984;Hall et al, 1993;Hall et al, 2002;Van Ryn et al, 2006). However, to assume a causal pathway from perception to communication would be premature.…”

Section: Discussionsupporting

confidence: 84%

“…Quality of care may also be affected by physicians' perceptions of patients. For example, physicians' liking for their patients has been associated with patients' ratings of satisfaction with care and more positive evaluations of the physician's behavior (Hall, Epstein, DeCiantis & McNeil, 1993;Hall, Horgan, Stein & Roter, 2002). Moreover, physicians' communication and perceptions of patients appear to be interconnected.…”

Section: Introductionmentioning

confidence: 99%

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Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor?

Street

Gordon

Haidet

2007

Social Science & Medicine

442

359

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Although physicians' communication style and perceptions affect outcomes, few studies have examined how these perceptions relate to the way physicians communicate with patients. Moreover, while any number of factors may affect the communication process, few studies have analyzed these effects collectively in order to identify the most powerful influences on physician communication and perceptions. Adopting an ecological approach, this investigation examined: (a) the relationships of physicians' patient-centered communication (informative, supportive, partnership-building) and affect (positive, contentious) on their perceptions of the patient, and (b) the degree to which communication and perceptions were affected by the physicians' characteristics, patients' demographic characteristics, physician-patient concordance, and the patient's communication. Physicians (N = 29) and patients (N = 207) from 10 outpatient settings in the United States participated in the study. From audio-recordings of these visits, coders rated the physicians' communication and affect as well as the patients' participation and affect. Doctors were more patientcentered with patients they perceived as better communicators, more satisfied, and more likely to adhere. Physicians displayed more patient-centered communication and more favorably perceived patients who expressed positive affect, were more involved, and who were less contentious. Physicians were more contentious with black patients, whom they also perceived as less effective communicators and less satisfied. Finally, physicians who reported a patient-centered orientation to the doctor-patient relationship also were more patient-centered in their communication. The results suggest that reciprocity and mutual influence have a strong effect on these interactions in that more positive (or negative) communication from one participant leads to similar responses from the other. Physicians' encounters with black patients revealed communicative difficulties that may lower quality of care for these patients.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor?

Street

Gordon

Haidet

2007

Social Science & Medicine

442

359

View full text Add to dashboard Cite

show abstract

“…We found that participants did not necessarily perceive favorite patients to be those most similar to them, instead, favorite patients were often people whose physicians had known a long time, and whose personalities 'clicked' with their physician. While previous studies have established that physicians had elevated liking for healthier patients [6], favorite patients in this study were often those who are sicker or had faced medical adversity together with their physician. Physicians found their relationships with many patients to be rewarding-not just their favorite patients-indeed many patients share traits with favorite patients, but not everyone is considered a favorite.…”

Section: Discussionmentioning

confidence: 94%

“…While celebrating the benefits of these relationships, physicians should also be aware of how their patients respond and that favorite relationships do not adversely affect the patient experience. Many patients worry about trying to please their physicians, and patient confidence in their care may also be weakened by the belief that their care is not as good than those of other patients [6].…”

Section: Practice Implicationsmentioning

confidence: 99%

“…It is not clear whether this applies to patient-physician relationships. Previous research has revealed that physicians have higher levels of respect for older patients and like those in better health more than other patients [5][6][7]. The concept of physicians liking their patients or vice versa is has been considered in the context of boundary crossing for physicians and therapists [8][9][10][11] and the dangers of treating some patients better than others [12,13].…”

Section: Introductionmentioning

confidence: 99%

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A qualitative exploration of favorite patients in primary care

Lee

Beach

Berger

et al. 2016

Patient Education and Counseling

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Objective-To ascertain whether physicians have favorite patients, their experiences with such patients, and how such relationships may influence patients and physicians.Methods-Semi-structured key informant interviews with 25 primary care internists practicing in several clinic settings at a large academic medical center.Results-The term 'favorite patient' raised concerns regarding boundaries and favoritism. Nevertheless, most participants (22/25) reported having favorite patients. For many physicians, favorite patients were not necessarily the most compliant patients, or those most similar to them. Instead, favorite patients were often very sick patients and/or those who have known their physicians for a long time. Many of these relationships were defined by experiences that strengthened the patient-physician bond. Participants felt that the favorite patient bond had a positive effect on patients and physicians ("it improves my day"). Physicians also discussed their challenging patients unprompted. Participants voiced that being cognizant of having favorite and challenging patients help to prevent favoring the care of certain patients over others.Conclusions & Practice Implications-Primary care physicians value patient relationships and benefit from deep bonds. A better understanding of how favorite patients affect primary care physicians could help inform and improve relationships with all patients.

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Hidden in Plain Sight<subtitle>Medical Visit Companions as a Resource for Vulnerable Older Adults</subtitle>

Wolff¹

2008

Arch Intern Med

189

204

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Background: Sicker patients are less satisfied with the quality of health care they receive than their healthier counterparts. Methods: A sample of 12 018 community-dwelling Medicare beneficiaries 65 years or older from the 2004 Medicare Current Beneficiary Survey was studied. Multivariate regression was used to describe whether beneficiaries' self-reported satisfaction with their usual-care physician was related to the presence or functions assumed by visit companions. Results: Overall, 38.6% of beneficiaries reported being typically accompanied to routine medical visits. Accompanied beneficiaries were older, less educated, and in worse health than their unaccompanied counterparts. More than 60% of companions facilitated visit communication by recording physician instructions (44.1%), providing information regarding patients' medical conditions or needs (41.6%), asking questions (41.1%), or explaining physicians' instructions (29.7%). After controlling for sociodemographic and health differences, accompanied beneficiaries were more highly satisfied with their physician's technical skills (odds ratio [OR],1.15; 95% confidence interval [CI], 1.02-1.30), information giving (OR, 1.19; 95% CI, 1.05-1.35), and interpersonal skills (OR,1.18; 95% CI, 1.03-1.35) than unaccompanied beneficiaries. Accompanied beneficiaries whose visit companions were more actively engaged in communication rated physician information giving (OR, 1.42; 95% CI, 1.14-1.77) and interpersonal skills (OR, 1.29; 95% CI, 1.05-1.59) more favorably. This relationship was strongest among beneficiaries with the worst self-rated health. Conclusions: Visit companions are commonly present in older adults' routine medical encounters, actively engaged in care processes, and influential to patients' satisfaction with physician care. More systematic recognition and integration of visit companions in health care processes may benefit quality of care for a particularly vulnerable patient population.

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Liking in the physician–patient relationship

Cited by 179 publications

References 22 publications

Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor?

Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor?

A qualitative exploration of favorite patients in primary care

Hidden in Plain Sight<subtitle>Medical Visit Companions as a Resource for Vulnerable Older Adults</subtitle>

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