October 2020

Improved Patient-Provider Relationship Boosts Outcomes

While a good patient-provider relationship has been the bedrock of today’s much-needed patient satisfaction scores, such relationships are also proving to boost functional outcomes.

In a recent study published in the Annals of Family Medicine1, physician researchers from Case Western Reserve University used data from the Medical Expenditure Panel Survey (MEPS) from 2015 and 2016 to measure both improvements in patient-provider relationships and functional health status over the course of the year.

The researchers assessed relationship quality by asking adult patients (average age 52.7 years [SD = 17.7 years], 59.4% female) whether they believed their provider listened to them and whether their provider explained concepts in an understandable way. In total, the researchers used 14 questions to assess relationship quality, and then looked at whether relationship quality and functional health status improved at the start and end of the study.

As might be expected, good patient-provider relationships were positively associated with functional status. But when looking at the trajectory, when those relationships improved over the course of the year, the patients’ functional health status improved by a correlation coefficient of between 0.05 and 0.08. The inverse was true as well: when relationships did not improve, or deteriorated, functional status followed in that downward manner.

Patients with 5 or more comorbidities were likely to experience a poor relationship with their provider than healthier counterparts. This discrepancy, the authors wrote, could signal an opportunity for intervention.

Their work builds on that of others about the benefits of good, ongoing patient-provider relationships. Indeed, researchers from Stanford University identified 5 best practices for patient-provider relationships and communication strategies. These include:2

  • Prepare with intention (take a moment to prepare and focus before greeting a patient)
  • Listen intently and completely (sit down, lean forward, avoid interruptions)
  • Agree on what matters most (find out what the patient cares about and incorporate these priorities into the visit agenda)
  • Connect with the patient’s story (consider life circumstances that influence the patient’s health; acknowledge positive efforts; celebrate successes)
  • Explore emotional cues (notice, name, and validate the patient’s emotions)
REFERENCES
  1. Olaisen RH, Schluchter MD, Flocke SA, et al. Assessing the longitudinal impact of physician-patient relationship on functional health. Ann Fam Med. 2020;18(5):422-429.
  2. Zulman DM, Haverfield MC, Shaw JG, et al. Practices to foster physician presence and connection with patients in the clinical encounter. JAMA. 2020;323(1):70–81.

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