Patient-Doctor Relationship Influences Health Outcome

By Smaranda Biliuti on January 27th, 2011 07:06 GMT

A new study focusing on the influence of the patient-clinician relationship has on patient's health outcome, concluded that 'difficult' patients are more likely to experience worse symptoms.

Sheri Hinchey from the Tripler Army Medical Center in Honolulu and Jeffrey Jackson from the Zablocki VA Medical Center in Milwaukee, are the two researchers who led this study, and they say that, in the short-term, a negative patient-clinician encounter has a negative impact on patients' health outcomes.

The study involved 750 adults who attended a primary care walk-in clinic.

Before the consult, the patients' symptoms were assessed, as well as their expectations, general health, physical, social and emotional functioning, and whether or not they had any mental disorders.

Right after their visit, they were asked whether they were satisfied with the consultation, if they had any unmet expectations and whether or not they trusted the doctor.

Two weeks later, the patients' symptoms were checked again, but this time, clinicians were also asked to rate the difficulty of every encounter.

The results showed that 18% of patients were perceived as difficult by the doctors, and they were also less likely to trust or to be satisfied with their physician.

This can only mean that both patients and doctors contributed to these 'difficult' encounters.

As a result, 'difficult' patients had more symptoms, worse functional status, used the clinic more frequently and were more likely to have an underlying psychiatric disorder, than non-difficult patients.

Clinicians who were more communicative and more open, as well as those with more experience, reported fewer difficult encounters.

The 'difficult' patients are also more likely to report worse symptoms two weeks after the consultation.

This new study is different from all previous research because the majority of studies to date, focused on patient characteristics alone.

Hinchey and Jackson wanted to see the fuller picture, and this is why they took into account both patient and clinician factors, as well as the impact of 'difficult' encounters on patient health outcomes.

Their work has just been published online in the Journal of General Internal Medicine.
A doctor talks to a patient with a broken neck at a triage center at Livingston Hospital.
   A doctor talks to a patient with a broken neck at a triage center at Livingston Hospital.
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