Family Practice Vol. 21, No. 1, 114-115
© Oxford University Press 2004, all rights reserved.
Correspondence |
Doctor–patient communication: emerging challenges
Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
E-mail: ghosh.amit{at}mayo.edu
The recent article by Ohtaki and colleagues1 provides a unique opportunity to study the difference between patient–physician communication in Japan and the USA. The difference in the communication styles were thought to arise mainly from cultural factors, though there could be other factors, including physician gender (all males), physician specialty and patient mix, which could explain some of the results.
Hall et al.2 have classified physicians' utterances into one of five broad categories. The categories were: information giving (all information and counselling statements); information seeking (all open- and closed-ended questions except asking for the patient's opinion); social talk (personal conversation unrelated to health); positive talk (laughter, approval, empathy, concern and reassurance/optimism); and partnership building (seeking/clarifying the patient's opinions, ideas or questions). It would be interesting to have analysed the current data using this format too. The reason for a longer time taken for physical examination is unclear since these patients were examined in detail at their previous visits.
It is also unclear whether the decreased time spent by the US physicians was due to practice concerns, i.e. managed care. Also the inclusion of specialists in Japan compared with family physician in the USA could result in the increased tolerance for uncertainty by the latter, and lesser reliance on repeated confirmatory physical examinations (as these patients had been examined in detail at least once before). Lastly, the patient mix of more males than females could affect the generalizability of this study as the gender ratio of female to male patients is generally higher in general practice.
References
1 Ohtaki S, Ohtakhi T, Fetters MD. Doctor–patient communication: a comparison of the USA and Japan. Fam Pract 2003; 20: 276–282.
2 Hall JA, Roter DL, Katz NR. Meta-analysis of correlates of provider behaviour in medical encounters. Med Care 1988; 26: 657–675.[Web of Science][Medline]
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