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Journal of General Internal Medicine May 2022A trusting physician-patient relationship is an essential component of high-quality care.
BACKGROUND
A trusting physician-patient relationship is an essential component of high-quality care.
OBJECTIVE
To explore the relationship between the physician-patient relationship, physician empathy, and patient trust.
DESIGN
Cross-sectional survey.
PARTICIPANTS
A total of 3289 patients (response rate 68.6%) from 103 hospitals in eastern, central, and western China completed surveys.
MAIN MEASURE
Physician empathy, patient trust, and physician-patient relationship were measured by the Chinese version of Consultation and Relational Empathy Scale, Wake Forest Physician Trust Scale, and Patient-Doctor Relationship Questionnaire, respectively. Bootstrapped mediation analysis was performed.
KEY RESULTS
There were moderate to strong correlations between physician empathy, patient overall trust, and patient trust in physician's benevolence and competence, and the physician-patient relationship (r = 0.49-0.75, P < 0.01 for all). Patients' evaluation of physician-patient relationship was predicted by their perception of physician empathy, patient overall trust, and trust in the physician's benevolence. Mediation analysis showed that the indirect effect of physician empathy on physician-patient relationship through patient overall trust was significant (β = 0.18, 95% CI: 0.15-0.21) and that the mediation effect of patient trust in physician's benevolence was significant (β = 0.24, 95% CI: 0.20-0.28), though the mediation effect of patient trust in physician's competence was not (β = 0.01, 95% CI: -0.02 to 0.02).
CONCLUSIONS
Patients' perception of physician empathy influences their evaluation of the physician-patient relationship both directly and indirectly via patient trust in the physician's benevolence. These findings underline the importance of patient belief in physician benevolence and empathy in building trustful and harmonious relationships between physicians and patients.
Topics: Cross-Sectional Studies; Empathy; Humans; Physician-Patient Relations; Physicians; Surveys and Questionnaires; Trust
PubMed: 34405348
DOI: 10.1007/s11606-021-07008-9 -
CMAJ : Canadian Medical Association... Jun 2021
Topics: Attitude to Death; Humans; Physician-Patient Relations; Physicians
PubMed: 34099472
DOI: 10.1503/cmaj.210405 -
International Journal of Environmental... Sep 2019Patient satisfaction is a measure of the extent to which a patient is content with the health care they received from their health care provider. Patient satisfaction is...
Patient satisfaction is a measure of the extent to which a patient is content with the health care they received from their health care provider. Patient satisfaction is one of the most important factors to determine the success of a health care facility. The purpose of this study was to determine patient satisfaction with healthcare services and encompass the physician's behavior as moderation between patient satisfaction and healthcare services. The study seeks to measure the health care services, like a laboratory and diagnostic care, preventive healthcare and prenatal care, to patient satisfaction in the public health sectors of Pakistan. A descriptive survey research design was used for this study. The target population was patients from the out-patient department (OPD) of three public hospitals from Pakistan. By using the convenient sampling technique, 290 sample participants were selected from the target population. The reliability scales were tallied by using Cronbach's Alpha. The findings of the study are gleaned by using regression to explore patient satisfaction with the health care services, and whether or not the physician's behavior moderates the link of patient satisfaction and healthcare services. SPSS Hayes process was used for the moderation effect of the physician's behavior. The main results of the regression analysis validate that health care services, such as laboratory and diagnostic care, preventive healthcare, and prenatal care, have a significant and positive effect on patient satisfaction. Specifically, the study suggests that the physician's behavior significantly moderates the effect of health care services on the satisfaction of patients. The overall opinions about the satisfaction level of patients for the availability of health services in the hospitals were good. The degree of satisfaction was satisfactory with respect to laboratory and diagnostic care, preventive healthcare, and prenatal care services. Based on the outcomes, the study confirms that the proposed hypotheses are statistically significant. Furthermore, the directions for future research of the study are offered.
Topics: Adult; Aged; Aged, 80 and over; Female; Health Services; Hospitals, Public; Humans; Male; Middle Aged; Outpatients; Pakistan; Patient Satisfaction; Physicians; Young Adult
PubMed: 31505840
DOI: 10.3390/ijerph16183318 -
The Pan African Medical Journal 2021in the DRC, doctors, formerly absent, are increasingly being employed as primary care physicians, in particular but not exclusively in urban areas. This study describes...
INTRODUCTION
in the DRC, doctors, formerly absent, are increasingly being employed as primary care physicians, in particular but not exclusively in urban areas. This study describes and analyses the impact of primary care physician services on the integrated district health system in Kisangani, DRC.
METHODS
in the third quarter of 2018, we conducted 40 semi-structured interviews of health district stakeholders (population, nurses, doctors, managers) selected in a reasoned way. Questions focused on doctors' motivation, their package of activities and the perceptions of other district stakeholders on their front-line services. Data were analysed using the thematic content analysis.
RESULTS
the services of primary care physicians were a de facto but they were unplanned and unsupported. This derived largely from doctors' need for professional integration. This seemed to improve treatment acceptability but limited their financial accessibility. It was associated with an uncontrolled expansion of the activity packages and caused competition between first-line and second-line physicians.
CONCLUSION
physician services are a challenge and an opportunity to strengthen first-line care while preserving complementarity with second-line care. A (re)definition of first-line physicians' role and activity package is then required. Hence, the need to improve the dialogue between different health system actors in order to (re)define consensually a model of first-line care adapted to match physicians' needs.
Topics: Attitude of Health Personnel; Delivery of Health Care, Integrated; Democratic Republic of the Congo; Humans; Interviews as Topic; Motivation; Physician's Role; Physicians, Primary Care; Primary Health Care; Qualitative Research
PubMed: 34630827
DOI: 10.11604/pamj.2021.39.215.25737 -
JAMA May 2023
Topics: Adaptation, Psychological; Grief; Narrative Medicine; Critical Care; Physicians
PubMed: 37022705
DOI: 10.1001/jama.2023.4747 -
Sante Publique (Vandoeuvre-les-Nancy,... 2021E-reputation is the reputation of an entity on the Internet. This phenomenon lies within numerous domains, including the medical sector. The primary objective of this...
INTRODUCTION
E-reputation is the reputation of an entity on the Internet. This phenomenon lies within numerous domains, including the medical sector. The primary objective of this study was to describe the general practitioners' interest for their e-reputation and the e-reputation data available in the PACA region. The secondary objectives were to identify the determinants of the doctors' interest and feeling of control of their e-reputation.
METHODS
The study was descriptive. The final sample was made of 240 physicians chosen randomly.The data collection has been done with a self-administered questionnaire and with a direct data collection on the Internet.
RESULTS
The questionnaire answer rate was 64,2%. 51,3% of respondent physicians had no interest for their e-reputation, 9,7% had a strong or very strong interest. Physicians established for less than 25 years and physicians aged under 50 had more interest. 79,9% of respondent physicians considered to have no control of their online reputation (median value = 1). 71,6% out of the 240 interrogated physicians had at least one evaluation. The average number of evaluation per physician was 3,65 (standard deviation = 3,92). Physicians aged over 50 and physicians practising in urban area received a higher number of evaluations. 44,8% of physicians would like to be further informed on the way to answer opinions on the Internet.
DISCUSSION
The physician's interest for their e-reputation was low. Their control was weak. They are however impacted by this phenomenon and are asking for information.
Topics: Aged; Attitude; General Practitioners; Humans; Surveys and Questionnaires
PubMed: 35724085
DOI: 10.3917/spub.213.0379 -
HEC Forum : An Interdisciplinary... Sep 2021This article attempts to motivate a reorientation of ethical analysis of conscientious objection (CO) by physicians. First, it presents an illustrative case from a...
This article attempts to motivate a reorientation of ethical analysis of conscientious objection (CO) by physicians. First, it presents an illustrative case from a hospital emergency department for context. Then, it criticizes the standard pro- and anti-CO arguments. It proposes that the fault in standard approaches is to focus on the ethics of the physician's behavior, and a better way forward on this issue is to ask how the party against whom the physician exercises the CO ought to respond. It connects this question with recent trends in physician employment models, which suggest that CO may become a potential source of conflict in the future. The article then develops a relational account of CO that extends James Childress' insights about the nature of CO in "Appeals to Conscience" (1979). This relational account characterizes CO as a two-place relation between conscientious objector and expectant party, in which the conscientious objector makes a request of the expectant party, which has implications that will be welcome and unwelcome for both the pro- and anti-CO camps. Finally, the paper applies this relational account of CO to the case when the physician is an employee. This application demonstrates that it is highly context dependent whether or not an employer should accede to the CO requests of physician-employees.
Topics: Conscience; Dissent and Disputes; Employment; Humans; Physicians
PubMed: 31745749
DOI: 10.1007/s10730-019-09390-8 -
JAMA May 2024
Topics: Female; Humans; Clinical Competence; Critical Care; Interprofessional Relations; Physicians; Sex Factors; Work-Life Balance
PubMed: 38602672
DOI: 10.1001/jama.2024.2937 -
Academic Medicine : Journal of the... Apr 2021Support of the U.S. health professions investigator workforce is critically important to the continued advancement of health care nationally. Physician-investigators...
Support of the U.S. health professions investigator workforce is critically important to the continued advancement of health care nationally. Physician-investigators comprise one segment of this health professions investigator workforce, which also includes investigators in the nursing, pharmacy, and dentistry professions, and others. Among physician health professionals in particular, the term "physician-investigator" has been described as encompassing physicians engaged in research in various ways including "clinical researchers" (physicians with clinical duties who do clinical, patient-centered research), "clinician-scientists" (physicians with clinical roles who perform research in laboratories or using computational tools), and "physician-scientists" (physicians focused on research with little or no clinical activity). Broadly defined, physician-investigators are included in various groups of researchers described in several articles recently published in Academic Medicine; these articles provide details on a range of approaches, with supporting outcomes data, being taken to train, support, and retain physicians in the health professions investigator workforce. The authors of this commentary examine selected literature, including several articles in this issue among others, along with Association of American Medical Colleges data, to offer observations about programs that train physician-investigators. Evidence-informed single-program approaches for early-career researchers can sustain continued research interest and foster the career development of the emerging physician-investigator workforce. Collaborative multi-institutional approaches offer the benefit of multisite work to power outcomes studies and to increase generalizability beyond a specific institutional program. System-wide institutional approaches may be particularly critical in supporting physician-investigators across all career stages. Although the articles discussed in this commentary are largely (although not exclusively) focused on various initiatives and programs designed to develop and sustain the physician-investigator workforce, such initiatives and programs may have value in addressing shared challenges of developing, supporting, and retaining the broader investigator workforce across all health professions.
Topics: Adult; Biomedical Research; Career Choice; Female; Forecasting; Health Personnel; Humans; Male; Middle Aged; Physicians; Research Personnel; United States; Workforce
PubMed: 33496430
DOI: 10.1097/ACM.0000000000003944 -
Health Economics Jul 2022Hospital-physician integration has surged in recent years. Integration may allow hospitals to share resources and management practices with their integrated physicians...
Hospital-physician integration has surged in recent years. Integration may allow hospitals to share resources and management practices with their integrated physicians that increase the reported diagnostic severity of their patients. Greater diagnostic severity will increase practices' payment under risk-based arrangements. We offer the first analysis of whether hospital-physician integration affects providers' coding of patient severity. Using a two-way fixed effects model, an event study, and a stacked difference-in-differences analysis of 5 million patient-year observations from 2010 to 2015, we find that the integration of a patient's primary care doctor is associated with a robust 2%-4% increase in coded severity, the risk-score equivalent of aging a physician's patients by 4-8 months. This effect was not driven by physicians treating different patients nor by physicians seeing patients more often. Our evidence is consistent with the hypothesis that hospitals share organizational resources with acquired physician practices to increase the measured clinical severity of patients. Increases in the intensity of coding will improve vertically-integrated practices' performance in alternative payment models and pay-for-performance programs while raising overall health care spending.
Topics: Delivery of Health Care; Hospitals; Humans; Physicians; Reimbursement, Incentive; United States
PubMed: 35460314
DOI: 10.1002/hec.4516