Doctors don't 'get' their patients

US physicians are often poor judges of their patients' health beliefs, according to a new study by Dr. Richard Street from Texas A&M University and Paul Haidet from The Pennsylvania State University College of Medicine, USA. However, physicians' understanding is better the more patients are involved by asking questions, expressing concerns, and stating their beliefs and preferences for care. Their analysis¹ of how patients' health beliefs differ from their physicians' perception of these beliefs was just published online by Springer in the Journal of General Internal Medicine².

207 physician-patient consultations were audio-recorded and, after the consultations, both physicians and patients completed a measure of beliefs about the cause, meaning, treatment, and control of the patient's health condition. Physicians additionally completed the measure on how they thought the patient responded.

Drs. Street and Haidet found that physicians generally did not have a good understanding of patient's health beliefs, but their understanding was significantly better when patients more actively participated in the consultation. However, in the majority of areas, doctors actually thought that their patients' beliefs were similar to theirs.

In addition, physicians were poorer judges of African-Americans' preferences to be a partner in their care, the meaning of the condition to Hispanic patients, and beliefs about control when the patient was of a different race to them. In some cases, understanding was better when physicians and patient were of the same race or ethnicity.

Dr. Street said, "If physicians had a better understanding of their patients' beliefs about health, they could address any misconceptions or differences of opinion they had with the patient regarding the nature, severity, and treatment of their illnesses as well as make treatment recommendations better suited to the patient's life circumstances. Encouraging the patient to be more involved in the consultation by expressing their beliefs and concerns is one way physicians can gain this understanding."

Dr. Haidet adds, "When doctors take time to listen to what the patient has to say, they can get a wealth of information about the lens through which patients make sense of their health. This can help them be better doctors."