Physician-patient communication following invasive procedures: An analysis of post-angiogram consultations

Research output: Contribution to journalArticle

Howard S. Gordon, Richard L. Street, P. Adam Kelly, Julianne Souchek, Nelda Wray

Although rarely studied, physician-patient interactions immediately following diagnostic tests are significant medical events because during these encounters the physician and patient often make decisions about major and sometimes invasive treatment. This investigation analyzed patterns of physician-patient communication following coronary angiography with particular attention to behaviors important to decision-making: physician information-giving, physician use of partnership-building, and active forms of patient participation (e.g., asking questions, being assertive, expressing concerns). We were particularly interested in effects related to the patient's race in light of documented evidence of racial disparities in cardiac care and outcomes. From audiotape recordings, 93 physician-patient interactions after coronary angiogram in a catheterization laboratory in a large US Veterans Affairs Medical Center were coded to measure the frequency of physicians' information-giving and partnership-building and the frequency of active patient participation. We also stratified these behaviors according to whether the behavior was prompted (e.g., physician information in response to a patient's question; a patient's opinion solicited by the doctor) or self-initiated. Several findings were noteworthy. First, these interactions were very brief and dominated by the physician. Second, although physician information-giving increased with more active patient participation, which in turn was correlated with physicians' use of partnership-building, proportionally little of the physicians' information (8%) and active patient participation (9%) was directly prompted by the other interactant. Finally, there was a tendency for physicians to self-initiate less information giving to black patients and for black patients to self-initiate less active participation than white patients. Although these differences were attenuated when other variables (e.g., the physician's training, disease severity) were included in the analysis, the pattern suggests a potential cycle of passivity where certain patients tend to receive fewer informational resources and these patients in turn do less to prompt the doctor for more.

Original languageEnglish (US)
Pages (from-to)1015-1025
Number of pages11
JournalSocial Science and Medicine
Volume61
Issue number5
DOIs
StatePublished - Sep 1 2005

PMID: 15955403

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Physician-patient communication following invasive procedures : An analysis of post-angiogram consultations. / Gordon, Howard S.; Street, Richard L.; Adam Kelly, P.; Souchek, Julianne; Wray, Nelda.

In: Social Science and Medicine, Vol. 61, No. 5, 01.09.2005, p. 1015-1025.

Research output: Contribution to journalArticle

Harvard

Gordon, HS, Street, RL, Adam Kelly, P, Souchek, J & Wray, N 2005, 'Physician-patient communication following invasive procedures: An analysis of post-angiogram consultations' Social Science and Medicine, vol. 61, no. 5, pp. 1015-1025. https://doi.org/10.1016/j.socscimed.2004.12.021

APA

Gordon, H. S., Street, R. L., Adam Kelly, P., Souchek, J., & Wray, N. (2005). Physician-patient communication following invasive procedures: An analysis of post-angiogram consultations. Social Science and Medicine, 61(5), 1015-1025. https://doi.org/10.1016/j.socscimed.2004.12.021

Vancouver

Gordon HS, Street RL, Adam Kelly P, Souchek J, Wray N. Physician-patient communication following invasive procedures: An analysis of post-angiogram consultations. Social Science and Medicine. 2005 Sep 1;61(5):1015-1025. https://doi.org/10.1016/j.socscimed.2004.12.021

Author

Gordon, Howard S. ; Street, Richard L. ; Adam Kelly, P. ; Souchek, Julianne ; Wray, Nelda. / Physician-patient communication following invasive procedures : An analysis of post-angiogram consultations. In: Social Science and Medicine. 2005 ; Vol. 61, No. 5. pp. 1015-1025.

BibTeX

@article{13e9210eff9b4c568976a27303826ea3,
title = "Physician-patient communication following invasive procedures: An analysis of post-angiogram consultations",
abstract = "Although rarely studied, physician-patient interactions immediately following diagnostic tests are significant medical events because during these encounters the physician and patient often make decisions about major and sometimes invasive treatment. This investigation analyzed patterns of physician-patient communication following coronary angiography with particular attention to behaviors important to decision-making: physician information-giving, physician use of partnership-building, and active forms of patient participation (e.g., asking questions, being assertive, expressing concerns). We were particularly interested in effects related to the patient's race in light of documented evidence of racial disparities in cardiac care and outcomes. From audiotape recordings, 93 physician-patient interactions after coronary angiogram in a catheterization laboratory in a large US Veterans Affairs Medical Center were coded to measure the frequency of physicians' information-giving and partnership-building and the frequency of active patient participation. We also stratified these behaviors according to whether the behavior was prompted (e.g., physician information in response to a patient's question; a patient's opinion solicited by the doctor) or self-initiated. Several findings were noteworthy. First, these interactions were very brief and dominated by the physician. Second, although physician information-giving increased with more active patient participation, which in turn was correlated with physicians' use of partnership-building, proportionally little of the physicians' information (8{\%}) and active patient participation (9{\%}) was directly prompted by the other interactant. Finally, there was a tendency for physicians to self-initiate less information giving to black patients and for black patients to self-initiate less active participation than white patients. Although these differences were attenuated when other variables (e.g., the physician's training, disease severity) were included in the analysis, the pattern suggests a potential cycle of passivity where certain patients tend to receive fewer informational resources and these patients in turn do less to prompt the doctor for more.",
keywords = "Coronary angiography, Coronary arteriosclerosis, Patient characteristics, Physician-patient communication, USA",
author = "Gordon, {Howard S.} and Street, {Richard L.} and {Adam Kelly}, P. and Julianne Souchek and Nelda Wray",
year = "2005",
month = "9",
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doi = "10.1016/j.socscimed.2004.12.021",
language = "English (US)",
volume = "61",
pages = "1015--1025",
journal = "Social Science and Medicine",
issn = "0277-9536",
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}

RIS

TY - JOUR

T1 - Physician-patient communication following invasive procedures

T2 - Social Science and Medicine

AU - Gordon, Howard S.

AU - Street, Richard L.

AU - Adam Kelly, P.

AU - Souchek, Julianne

AU - Wray, Nelda

PY - 2005/9/1

Y1 - 2005/9/1

N2 - Although rarely studied, physician-patient interactions immediately following diagnostic tests are significant medical events because during these encounters the physician and patient often make decisions about major and sometimes invasive treatment. This investigation analyzed patterns of physician-patient communication following coronary angiography with particular attention to behaviors important to decision-making: physician information-giving, physician use of partnership-building, and active forms of patient participation (e.g., asking questions, being assertive, expressing concerns). We were particularly interested in effects related to the patient's race in light of documented evidence of racial disparities in cardiac care and outcomes. From audiotape recordings, 93 physician-patient interactions after coronary angiogram in a catheterization laboratory in a large US Veterans Affairs Medical Center were coded to measure the frequency of physicians' information-giving and partnership-building and the frequency of active patient participation. We also stratified these behaviors according to whether the behavior was prompted (e.g., physician information in response to a patient's question; a patient's opinion solicited by the doctor) or self-initiated. Several findings were noteworthy. First, these interactions were very brief and dominated by the physician. Second, although physician information-giving increased with more active patient participation, which in turn was correlated with physicians' use of partnership-building, proportionally little of the physicians' information (8%) and active patient participation (9%) was directly prompted by the other interactant. Finally, there was a tendency for physicians to self-initiate less information giving to black patients and for black patients to self-initiate less active participation than white patients. Although these differences were attenuated when other variables (e.g., the physician's training, disease severity) were included in the analysis, the pattern suggests a potential cycle of passivity where certain patients tend to receive fewer informational resources and these patients in turn do less to prompt the doctor for more.

AB - Although rarely studied, physician-patient interactions immediately following diagnostic tests are significant medical events because during these encounters the physician and patient often make decisions about major and sometimes invasive treatment. This investigation analyzed patterns of physician-patient communication following coronary angiography with particular attention to behaviors important to decision-making: physician information-giving, physician use of partnership-building, and active forms of patient participation (e.g., asking questions, being assertive, expressing concerns). We were particularly interested in effects related to the patient's race in light of documented evidence of racial disparities in cardiac care and outcomes. From audiotape recordings, 93 physician-patient interactions after coronary angiogram in a catheterization laboratory in a large US Veterans Affairs Medical Center were coded to measure the frequency of physicians' information-giving and partnership-building and the frequency of active patient participation. We also stratified these behaviors according to whether the behavior was prompted (e.g., physician information in response to a patient's question; a patient's opinion solicited by the doctor) or self-initiated. Several findings were noteworthy. First, these interactions were very brief and dominated by the physician. Second, although physician information-giving increased with more active patient participation, which in turn was correlated with physicians' use of partnership-building, proportionally little of the physicians' information (8%) and active patient participation (9%) was directly prompted by the other interactant. Finally, there was a tendency for physicians to self-initiate less information giving to black patients and for black patients to self-initiate less active participation than white patients. Although these differences were attenuated when other variables (e.g., the physician's training, disease severity) were included in the analysis, the pattern suggests a potential cycle of passivity where certain patients tend to receive fewer informational resources and these patients in turn do less to prompt the doctor for more.

KW - Coronary angiography

KW - Coronary arteriosclerosis

KW - Patient characteristics

KW - Physician-patient communication

KW - USA

UR - http://www.scopus.com/inward/record.url?scp=20444372663&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=20444372663&partnerID=8YFLogxK

U2 - 10.1016/j.socscimed.2004.12.021

DO - 10.1016/j.socscimed.2004.12.021

M3 - Article

VL - 61

SP - 1015

EP - 1025

JO - Social Science and Medicine

JF - Social Science and Medicine

SN - 0277-9536

IS - 5

ER -

ID: 3081334