UR Physician to Study Doctor-Patient Relationship and its Effect on Health Care Costs

October 05, 2000

What exactly is a sound patient-doctor relationship - in the eyes of the patient? How does the communication in the relationship affect patients? Those fundamental questions are the focus of a three-year study involving over 100 Rochester area physicians and their patients being conducted by researchers at the University of Rochester School of Medicine and Dentistry.

The study, funded through a $2 million grant from the Agency for Healthcare Quality and Research, builds on previous research studies conducted by Ronald Epstein, M.D. which have shown that factors such as a physician's technical and communication skills, the setting in which health care is delivered, and the patient's needs and demands influence the chances of that patient being referred to a specialist, given a prescription or being sent for a diagnostic test. Epstein is an associate professor of Family Medicine and Psychiatry at the University of Rochester.

"With this study, we hope to untangle some of the complicated factors that contribute to a patient's satisfaction with his or her doctor," Epstein said. "Patients can provide crucial information about certain aspects of the physician-patient communication."

The study will consider both verbal and non-verbal aspects of communication as well as other ways that doctors build relationships with their patients. "For instance, there are many ways to say, 'I think you have cancer'," he said. "Some of these elements of communication may seem obvious, but have never before been scientifically studied."

Epstein is currently recruiting 100 physicians in an eight-county area to participate in the study. Participating doctors agree to audiotaping of encounters with two "standardized" patients - individuals who portray a patient with a concern or symptom. In addition, fifty patients in the practice are asked to complete a confidential questionnaire, which probes issues such as their degree of satisfaction, health status and trust. Finally, the researchers will correlate findings of the standardized patient interviews and the results of the surveys with claims data on those physicians' care, such as prescriptions, referrals to specialists, diagnostic tests and procedures.

"I expect some surprises," he said. "There are lots of myths that surround the patient-doctor relationship. For instance, patients don't necessarily want a physician who is nice. Instead, they want someone who is clear and who listens carefully."

Epstein also suspects that there may be a relationship between communication and cost. "I think we'll find that there are elements of a physician-patient relationship that contribute to health care costs."

Physicians interested in enrolling in the study should contact Kit Miller at 442-7470 ext. 506.

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