Verbal compliance-gaining strategies used by male physicians and patient healthcare experience
DOI:
https://doi.org/10.1558/cam.17143Keywords:
adherence, compliance-gaining strategies, doctor–patient relationship, health communication, patient healthcare experience, patient satisfactionAbstract
This study explores male physicians’ use of verbal compliance gaining strategies to encourage patients to adhere to medication regimens, lifestyle changes, or future appointments, and assesses which strategies are associated with patients’ reported healthcare experiences. Five physicians from a family practice clinic in northern British Columbia, Canada, were audio-recorded while interacting with 31 patients during actual consultations. Compliance-gaining utterances were coded into five categories of strategies, while patient experience with care was assessed using a questionnaire. A number of intriguing findings emerged: direct orders were related to a more negative experience with interpersonal aspects of care, but were fairly frequently used, especially with female patients. Persuasion was the only strategy that promoted a positive patient experience, but was rarely used. However, the effect of persuasion on patient experience was no longer significant when adjusting for patients’ health status. Physicians relied mostly on motivation strategies to encourage adherence, but these strategies were not related to patients’ assessment of their healthcare experiences. These results suggest that the most frequently used verbal compliance gaining strategies by physicians are not always appreciated by patients. To be more effective, it is necessary to inform physicians about which compliance-gaining strategies promote a positive patient healthcare experience.References
Bennett, J. K., Fuertes, J. N., Keitel, M. and Phillips, R. (2011) The role of patient attachment and working alliance on patient adherence, satisfaction, and health related quality of life in lupus treatment. Patient Education and Counseling 85 (1): 53–59. https://doi.org/10.1016/j.pec.2010.08.005
Buller, M. K. and Buller, D. B. (1987) Physicians’ communication style and patient satisfaction. Journal of Health and Social Behavior 28 (4): 375–388. https://doi.org/10.2307/2136791
Bultman, D. C. and Svarstad, B. L. (2000) Effects of physician communication style on medication beliefs and adherence with antidepressant treatment. Patient Education and Counseling 40 (2): 173–185. https://doi.org/10.1016/s0738-3991(99)
00083-x
Burgoon, M., Parrott, R., Burgoon, J. K., Birk, T., Pfau, M. and Coker, R. (1990) Primary care physicians’ selection of verbal compliance-gaining strategies. Health Communication 2 (1): 13–27. https://doi.org/10.1207/s15327027hc0201_2
Burgoon, M., Parrott, R., Burgoon, J. K., Coker, R., Pfau, M. and Birk, T. (1990) Patients’ severity of illness, non-compliance, and locus of control and physicians’ compliance gaining messages. Health Communication 2 (1): 29–46.
Burgoon, J. K., Pfau, M., Parrott, R., Birk, T., Coker, R. and Burgoon, M. (1987) Relational communication, satisfaction, compliance-gaining strategies, and compliance in communication between physicians and patients. Communication Monographs 54 (3): 307–324. https://doi.org/10.1080/03637758709390235
Carpenter, D. M., DeVellis, R. F., Fisher, E. B., DeVellis, B. M., Hogan, S. L. and Jordan, J. M. (2010) The effect of conflicting medication information and physician support on medication adherence for chronically ill patients. Patient Education and Counseling 81 (2): 169–176. https://doi.org/10.1016/j.pec.2009.11.006
Chang, J. T., Hays, R. D., Shekelle, P. G., MacLean, C. H., Solomon, D. H., Reuben, D. B., Roth, C. P., Kamberg, C. J., Adams, J., Young, R. T. and Wenger, N. S. (2006) Patients’ global ratings of their health care are not associated with the technical quality of their care. Annals of Internal Medicine 144 (9): 665–672. https://doi.org/10.7326/0003-4819-144-9-200605020-00010
DiMatteo, M. R., Haskard-Zolnierek, K. B. and Martin, L. R. (2012) Improving patient adherence: A three-factor model to guide practice. Health Psychology Review 6 (1): 74–91. https://doi.org/10.1080/17437199.2010.537592
DiMatteo, M. R., Murray, C. B. and Williams, S. L. (2009) Gender disparities in physician-patient communication among African American patients in primary care. Journal of Black Psychology 35 (2): 204–227. https://doi.org/10.1177/0095798409333599
DiMatteo, M. R., Reiter, R. C. and Gambone, J. C. (1994) Enhancing medication adherence through communication and informed collaborative choice. Health Communication 6 (4): 253–265. https://doi.org/10.1207/s15327027hc0604_2
Falvo, D., Woehlke, P. and Deichmann, J. (1980) Relationship of physician behaviour to patient compliance. Patient Counseling and Health Education 2 (4): 185–188. https://doi.org/10.1016/S0738–3991(80)80101-7
Feng, B., Bell, R. A., Jerant, A. F. and Kravitz, R. L. (2011) What do doctors say when prescribing medications? An examination of medical recommendations from a communication perspective. Health Communication 26 (3): 286–296. https://doi.org/10.1080/10410236.2010.550020
Fenton, J. J., Jerant, A. F., Bertakis, K. D. and Franks, P. (2012) The cost of satisfaction: A national study of patient satisfaction, health care utilization, expenditures, and mortality. Archives of Internal Medicine 172 (5): 405–411. https://doi.org/10.1001/archinternmed.2011.1662
Greaves, F., Pape, U. J., King, D., Darzi, A., Majeed, A., Wachter, R. M. and Millett, C. (2012) Associations between web-based patient ratings and objective measures of hospital quality. Archives of Internal Medicine 172 (5): 435–436. https://doi.org/10.1001/archinternmed.2011.1675
Gupta, D., Markman, M., Rodeghier, M. and Lis, C. G. (2012) The relationship between patient satisfaction with service quality and survival in pancreatic cancer. Patient Preference and Adherence 6: 765–772. https://doi.org/10.2147/ppa.s37900
Hall, J. A. and Roter, D. L. (1995) Patient gender and communication with physicians: Results of a community-based study. Women’s Health 1 (1): 77–95.
Hall, J. A. and Roter, D. L. (2002) Do patients talk differently to male and female physicians? A meta-analytic review. Patient Education and Counseling 48 (3): 217–224.
Haskard-Zolnierek, K. B. and DiMatteo, M. R. (2009) Physician communication and patient adherence to treatment: A meta-analysis. Medical Care 47 (8): 826–834. https://doi.org/10.1097/mlr.0b013e31819a5acc
Haynes, R. B., McDonald, H. P. and Garg, A. X. (2002) Helping patients follow prescribed treatment: Clinical applications. Journal of the American Medical Association 288 (22): 2880–2883. https://doi.org/10.1001/jama.288.22.2880
Helme, D. W. and Harrington, N. G. (2004) Patient accounts for noncompliance with diabetes self-care regimens and physician compliance-gaining response. Patient Education and Counseling 55 (2): 281–292. https://doi.org/10.1016/j.pec.2003.10.004
Ho, L., Swartz, A. and Wasson, J. H. (2013) The right tool for the right job: The value of alternative patient experience measures. Journal of Ambulatory Care Management 36 (3): 241–244. https://doi.org/10.1097/jac.0b013e3182955b0f
Iliopulos, A. (2007) Resident Verbal Compliance Gaining Strategies. Unpublished BSc dissertation. University of Northern British Columbia, Canada.
Jefferson, L., Bloor K., Birks, Y., Hewitt, C. and Bland, M. (2013) Effect of physicians’ gender on communication and consultation length: A systematic review and meta-analysis. Journal of Health Services Research and Policy 18 (4): 242–248. https://doi.org/10.1177/1355819613486465
Jerant, A., Fenton, J. J., Bertakis, K. D. and Franks, P. (2014) Satisfaction with health care providers and preventive care adherence: A national study. Medical Care 52 (1): 78–85. https://doi.org/10.1097/mlr.0000000000000021
Levesque, A., Li, H. Z. and Pahal, J. S. (2012) Factors related to patients’ adherence to medication and lifestyle change recommendations: Data from Canada. International Journal of Psychological Studies 4 (2): 42–55. https://doi.org/10.5539/ijps.v4n2p42
Li, H. Z., Desroches, N., Yum, O. K., Koehn, C. and Deagle, G. (2007) Asymmetrical talk between physicians and patients: A quantitative discourse analysis. Canadian Journal of Communication 32 (3): 417–433.
Manary, M. P., Boulding, W., Staelin, R. and Glickman, S. W. (2013) The patient experience and health outcomes. New England Journal of Medicine 368 (3): 201–203. https://doi.org/10.1056/nejmp1211775
Pahal, J. S. and Li, H. Z. (2006) The dynamics of resident-patient communication: Data from Canada. Communication and Medicine 3 (2): 161–170. https://doi.org/10.1515/cam.2006.018
Price, R. A., Elliott, M. N., Zaslavsky, A. M., Hays, R. D., Lehrman, W. G., Rybowski, L., Edgman-Levitan, S. and Cleary, P. D. (2014) Examining the role of patient experience surveys in measuring health care quality. Medical Care Research and Review 71 (5): 522–554.
Roter, D. L., Hall, J. A. and Aoki, Y. (2002) Physician gender effects in medical communication: A meta-analytic review. Journal of the American Medical Association 288 (6): 756–764. https://doi.org/10.1001/jama.288.6.756
Roter, D. L., Hall, J. A., Merisca, R., Nordstrom, B., Cretin, D. and Svarstad, B. (1998) Effectiveness of interventions to improve patient compliance: A meta-analysis. Medical Care 36 (8): 1138–1161. https://doi.org/10.1097/00005650-199808000-00004
Schoenthaler, A., Chaplin, W. F., Allegrante, J. P., Fernandez, S., Diaz-Gloster, M., Tobin, J. N. and Ogedegbe, G. (2009) Provider communication effects medication adherence in hypertensive African Americans. Patient Education and Counseling 75 (2): 185–191. https://doi.org/10.1016/j.pec.2008.09.018
Schoenthaler, A. M., Schwartz, B. S., Wood, C. and Stewart, W. F. (2012) Patient and physician factors associated with adherence to diabetes medications. The Diabetes Educator 38 (3): 397–408. https://doi.org/10.1177/0145721712440333
Shale, S. (2013) Patient experience as an indicator of clinical quality in emergency care. Clinical Governance: An International Journal 18 (4): 285–292. https://doi.org/10.1108/cgij-03-2012-0008
Smith, V. A., DeVellis, B. M., Kalet, A., Roberts, J. C. and DeVellis., R. F. (2005) Encouraging patient adherence: Primary care physicians’ use of verbal compliance-gaining strategies in medical interviews. Patient Education and Counseling 57 (1): 62–76. https://doi.org/10.1016/j.pec.2004.03.017
Stewart, M. (1984) Patient characteristics which are related to the doctor-patient interaction. Family Practice 1 (1): 30–36. https://doi.org/10.1093/fampra/1.1.30
Stewart, M. (1995) Effective physician-patient communication and health outcomes: A review. Canadian Medical Association Journal 152 (9): 1423–1433.
West, C. (1984) When the doctor is a ‘lady’: Power, status and gender in physician-patient encounters. Symbolic Interaction 7 (1): 87–106. https://doi.org/10.1525/si.1984.7.1.87
Wrench, J. S. and Booth-Butterfield, M. (2003) Increasing patient satisfaction and compliance: An examination of physician humor orientation, compliance-gaining strategies, and perceived credibility. Communication Quarterly 51 (4): 482–503. https://doi.org/10.1080/01463370309370169
Buller, M. K. and Buller, D. B. (1987) Physicians’ communication style and patient satisfaction. Journal of Health and Social Behavior 28 (4): 375–388. https://doi.org/10.2307/2136791
Bultman, D. C. and Svarstad, B. L. (2000) Effects of physician communication style on medication beliefs and adherence with antidepressant treatment. Patient Education and Counseling 40 (2): 173–185. https://doi.org/10.1016/s0738-3991(99)
00083-x
Burgoon, M., Parrott, R., Burgoon, J. K., Birk, T., Pfau, M. and Coker, R. (1990) Primary care physicians’ selection of verbal compliance-gaining strategies. Health Communication 2 (1): 13–27. https://doi.org/10.1207/s15327027hc0201_2
Burgoon, M., Parrott, R., Burgoon, J. K., Coker, R., Pfau, M. and Birk, T. (1990) Patients’ severity of illness, non-compliance, and locus of control and physicians’ compliance gaining messages. Health Communication 2 (1): 29–46.
Burgoon, J. K., Pfau, M., Parrott, R., Birk, T., Coker, R. and Burgoon, M. (1987) Relational communication, satisfaction, compliance-gaining strategies, and compliance in communication between physicians and patients. Communication Monographs 54 (3): 307–324. https://doi.org/10.1080/03637758709390235
Carpenter, D. M., DeVellis, R. F., Fisher, E. B., DeVellis, B. M., Hogan, S. L. and Jordan, J. M. (2010) The effect of conflicting medication information and physician support on medication adherence for chronically ill patients. Patient Education and Counseling 81 (2): 169–176. https://doi.org/10.1016/j.pec.2009.11.006
Chang, J. T., Hays, R. D., Shekelle, P. G., MacLean, C. H., Solomon, D. H., Reuben, D. B., Roth, C. P., Kamberg, C. J., Adams, J., Young, R. T. and Wenger, N. S. (2006) Patients’ global ratings of their health care are not associated with the technical quality of their care. Annals of Internal Medicine 144 (9): 665–672. https://doi.org/10.7326/0003-4819-144-9-200605020-00010
DiMatteo, M. R., Haskard-Zolnierek, K. B. and Martin, L. R. (2012) Improving patient adherence: A three-factor model to guide practice. Health Psychology Review 6 (1): 74–91. https://doi.org/10.1080/17437199.2010.537592
DiMatteo, M. R., Murray, C. B. and Williams, S. L. (2009) Gender disparities in physician-patient communication among African American patients in primary care. Journal of Black Psychology 35 (2): 204–227. https://doi.org/10.1177/0095798409333599
DiMatteo, M. R., Reiter, R. C. and Gambone, J. C. (1994) Enhancing medication adherence through communication and informed collaborative choice. Health Communication 6 (4): 253–265. https://doi.org/10.1207/s15327027hc0604_2
Falvo, D., Woehlke, P. and Deichmann, J. (1980) Relationship of physician behaviour to patient compliance. Patient Counseling and Health Education 2 (4): 185–188. https://doi.org/10.1016/S0738–3991(80)80101-7
Feng, B., Bell, R. A., Jerant, A. F. and Kravitz, R. L. (2011) What do doctors say when prescribing medications? An examination of medical recommendations from a communication perspective. Health Communication 26 (3): 286–296. https://doi.org/10.1080/10410236.2010.550020
Fenton, J. J., Jerant, A. F., Bertakis, K. D. and Franks, P. (2012) The cost of satisfaction: A national study of patient satisfaction, health care utilization, expenditures, and mortality. Archives of Internal Medicine 172 (5): 405–411. https://doi.org/10.1001/archinternmed.2011.1662
Greaves, F., Pape, U. J., King, D., Darzi, A., Majeed, A., Wachter, R. M. and Millett, C. (2012) Associations between web-based patient ratings and objective measures of hospital quality. Archives of Internal Medicine 172 (5): 435–436. https://doi.org/10.1001/archinternmed.2011.1675
Gupta, D., Markman, M., Rodeghier, M. and Lis, C. G. (2012) The relationship between patient satisfaction with service quality and survival in pancreatic cancer. Patient Preference and Adherence 6: 765–772. https://doi.org/10.2147/ppa.s37900
Hall, J. A. and Roter, D. L. (1995) Patient gender and communication with physicians: Results of a community-based study. Women’s Health 1 (1): 77–95.
Hall, J. A. and Roter, D. L. (2002) Do patients talk differently to male and female physicians? A meta-analytic review. Patient Education and Counseling 48 (3): 217–224.
Haskard-Zolnierek, K. B. and DiMatteo, M. R. (2009) Physician communication and patient adherence to treatment: A meta-analysis. Medical Care 47 (8): 826–834. https://doi.org/10.1097/mlr.0b013e31819a5acc
Haynes, R. B., McDonald, H. P. and Garg, A. X. (2002) Helping patients follow prescribed treatment: Clinical applications. Journal of the American Medical Association 288 (22): 2880–2883. https://doi.org/10.1001/jama.288.22.2880
Helme, D. W. and Harrington, N. G. (2004) Patient accounts for noncompliance with diabetes self-care regimens and physician compliance-gaining response. Patient Education and Counseling 55 (2): 281–292. https://doi.org/10.1016/j.pec.2003.10.004
Ho, L., Swartz, A. and Wasson, J. H. (2013) The right tool for the right job: The value of alternative patient experience measures. Journal of Ambulatory Care Management 36 (3): 241–244. https://doi.org/10.1097/jac.0b013e3182955b0f
Iliopulos, A. (2007) Resident Verbal Compliance Gaining Strategies. Unpublished BSc dissertation. University of Northern British Columbia, Canada.
Jefferson, L., Bloor K., Birks, Y., Hewitt, C. and Bland, M. (2013) Effect of physicians’ gender on communication and consultation length: A systematic review and meta-analysis. Journal of Health Services Research and Policy 18 (4): 242–248. https://doi.org/10.1177/1355819613486465
Jerant, A., Fenton, J. J., Bertakis, K. D. and Franks, P. (2014) Satisfaction with health care providers and preventive care adherence: A national study. Medical Care 52 (1): 78–85. https://doi.org/10.1097/mlr.0000000000000021
Levesque, A., Li, H. Z. and Pahal, J. S. (2012) Factors related to patients’ adherence to medication and lifestyle change recommendations: Data from Canada. International Journal of Psychological Studies 4 (2): 42–55. https://doi.org/10.5539/ijps.v4n2p42
Li, H. Z., Desroches, N., Yum, O. K., Koehn, C. and Deagle, G. (2007) Asymmetrical talk between physicians and patients: A quantitative discourse analysis. Canadian Journal of Communication 32 (3): 417–433.
Manary, M. P., Boulding, W., Staelin, R. and Glickman, S. W. (2013) The patient experience and health outcomes. New England Journal of Medicine 368 (3): 201–203. https://doi.org/10.1056/nejmp1211775
Pahal, J. S. and Li, H. Z. (2006) The dynamics of resident-patient communication: Data from Canada. Communication and Medicine 3 (2): 161–170. https://doi.org/10.1515/cam.2006.018
Price, R. A., Elliott, M. N., Zaslavsky, A. M., Hays, R. D., Lehrman, W. G., Rybowski, L., Edgman-Levitan, S. and Cleary, P. D. (2014) Examining the role of patient experience surveys in measuring health care quality. Medical Care Research and Review 71 (5): 522–554.
Roter, D. L., Hall, J. A. and Aoki, Y. (2002) Physician gender effects in medical communication: A meta-analytic review. Journal of the American Medical Association 288 (6): 756–764. https://doi.org/10.1001/jama.288.6.756
Roter, D. L., Hall, J. A., Merisca, R., Nordstrom, B., Cretin, D. and Svarstad, B. (1998) Effectiveness of interventions to improve patient compliance: A meta-analysis. Medical Care 36 (8): 1138–1161. https://doi.org/10.1097/00005650-199808000-00004
Schoenthaler, A., Chaplin, W. F., Allegrante, J. P., Fernandez, S., Diaz-Gloster, M., Tobin, J. N. and Ogedegbe, G. (2009) Provider communication effects medication adherence in hypertensive African Americans. Patient Education and Counseling 75 (2): 185–191. https://doi.org/10.1016/j.pec.2008.09.018
Schoenthaler, A. M., Schwartz, B. S., Wood, C. and Stewart, W. F. (2012) Patient and physician factors associated with adherence to diabetes medications. The Diabetes Educator 38 (3): 397–408. https://doi.org/10.1177/0145721712440333
Shale, S. (2013) Patient experience as an indicator of clinical quality in emergency care. Clinical Governance: An International Journal 18 (4): 285–292. https://doi.org/10.1108/cgij-03-2012-0008
Smith, V. A., DeVellis, B. M., Kalet, A., Roberts, J. C. and DeVellis., R. F. (2005) Encouraging patient adherence: Primary care physicians’ use of verbal compliance-gaining strategies in medical interviews. Patient Education and Counseling 57 (1): 62–76. https://doi.org/10.1016/j.pec.2004.03.017
Stewart, M. (1984) Patient characteristics which are related to the doctor-patient interaction. Family Practice 1 (1): 30–36. https://doi.org/10.1093/fampra/1.1.30
Stewart, M. (1995) Effective physician-patient communication and health outcomes: A review. Canadian Medical Association Journal 152 (9): 1423–1433.
West, C. (1984) When the doctor is a ‘lady’: Power, status and gender in physician-patient encounters. Symbolic Interaction 7 (1): 87–106. https://doi.org/10.1525/si.1984.7.1.87
Wrench, J. S. and Booth-Butterfield, M. (2003) Increasing patient satisfaction and compliance: An examination of physician humor orientation, compliance-gaining strategies, and perceived credibility. Communication Quarterly 51 (4): 482–503. https://doi.org/10.1080/01463370309370169
Published
2017-05-04
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How to Cite
Levesque, A., & Li, H. Z. (2017). Verbal compliance-gaining strategies used by male physicians and patient healthcare experience. Communication and Medicine, 13(2), 185-202. https://doi.org/10.1558/cam.17143
