Section B: Consultation Style

16 important questions on Section B: Consultation Style

With a lot of these types of studies (i.e. whether patient-centred or doctor centred style is better), there is a mixed bag of results. Why do you think this is?

This can be determined by/related to the context or situation in which people are asked to be involved in a shared decision-making process.

Differences in methodology

What are some issues with communication research?

1. Research exploring the interaction between health professional and patient uses a variety of methods. Some studies ask each party about the interaction, some record the interaction, some code the interaction and some observe the interaction

2. The research is not clear about what happens when the doctor's and patient's opinion clash 

(p. 80 textbook)

From a patient's perspective, 2 needs have to be met to have a successful patient-doctor communication. What are they?

  1. The need to know and understand
  2. The need to feel known and to be understood


(p. 70 Berry textbook)
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What did Berry (2004) say?

A patient-centred style involves the doctor listening to the patient's point of view and expectations, and working with patients in the decision making and planning of treatment

What did Savage & Armstrong (1990) say?

Doctor-centred style = the doctor is perceived as the expert who communicates their knowledge to the naïve patient

What did Epstein et al. (2005) argue?

The goal of patient-centred communication is to help practitioners provide care that is concordant with the patient's values, needs and preferences

What did Coulter (1999) stress?

Coulter (1999) stressed the importance of a patient-centred consultation by arguing that the doctor is informed of diagnostic techniques, the causes of disease and treatment options but only the patient knows of their experience with the illness and how it impacts their lives. Both types of knowledge are needed to manage illness successfully.

What did Levinson et al. (2010) support?

Supported patient-centred communication in having a positive impact on patient satisfaction and medical adherence.

What is a limitation with Saha and Beach's (2011) study?

This study is highly hypothetical and thus may not reflect accurate consultation preferences in reality. Patel et al. (2002) argued that decision making in natural settings differs substantially from decision making in a laboratory situation in which most studies focus on a single decision making event.

-->Taking this evidence into account, the applicability of Saha & Beach’s (2011) study to the general population is limited.

What did Patel et al. (2002) argue?

That decision making in natural settings differs substantially from decision making in a laboratory situation in which most studies focus on a single decision making event.

What did Swenson et al. (2004) find that links with Saha and Beachs' (2011) study?

Patient-centred approach are associated with higher levels of education

What did McKinstry (2000) find?

Patient-centred approach are associated with higher levels of social class

What did Covey (2011) find?

That providing health information in relative risk format (as oppose to absolute risk) misled participants into preferring an inferior vaccine.

What did Marcatto et al. (2013) argue? Who is this study supported by?

Health professionals are also susceptible to decision biases by finding that physicians would more likely prescribe a treatment when its risk reduction was presented to them in relative rather than in absolute terms, a finding supported by Covey (2007).

What did Swenson et al. (2004) argue in terms of individual differences?

Argued that patients’ preferences regarding the degree of involvement in their care are highly variable; some patients prefer active participation while others wish to rely on their physicians to make decisions.

--> Therefore, doctor flexibility is important in the decision-making process so that individual differences in patient preferences are respected.

What did Lee and Lin (2010) examine?

Examined whether the effectiveness of patient-centred care is specific to the individual or universal in nature.

Results: autonomy preferences moderate the relationship between consulting style and satisfaction. The researchers indicated that patients with a higher autonomy preference preferred a patient-centred approach compared to those who wanted to be less involved in the treatment decision.

Limitation: the sample only consisted of older patients. Research has shown that older prefer a more passive role in decision making (Say et al. 2006), therefore the results may differ with a wider range of ages

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