Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-05T04:51:07.091Z Has data issue: false hasContentIssue false

Issues in Physician—Elderly Patient Interaction

Published online by Cambridge University Press:  14 November 2008

Ronald D. Adelman
Affiliation:
Chief, Division of Geriatrics, Winthrop-University Hospital; Assistant Professor, Department of Medicine, State University of New York at Stony Brook, Mineola, New York 11501, USA.
Michele G. Greene
Affiliation:
Associate Professor, Department of Health and Nutrition Sciences, Brooklyn College, Brooklyn, New York 11210, USA.
Rita Charont
Affiliation:
Assistant Professor of Clinical Medicine and Henry J. Kaiser Family Foundation Faculty Scholar in General Internal Medicine, Division of General Medicine, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA.

Extract

The basis of an effective and satisfactory physician–patient relationship is found in the communication which occurs between these two individuals. By studying the interaction, we can learn much about the identities of the physician and patient, and how they view each other and the world. The interactional dynamics between physician and patient are unique. For example, even in initial medical encounters which involve the meeting of two strangers, patients and physicians deal with concerns as diverse as life and death as well as other intimate or personal issues. Researchers of physician–patient interaction seek to discover how communication evolves and how that communication reveals the multiple levels of meaning in the medical encounter.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

NOTES

1 Davis, M., Variation in patients' compliance with doctors' orders: medical practice and doctor–patient interaction. Psychiatry in Medicine, 2 (1971), 3154.CrossRefGoogle ScholarPubMed

2 Freemon, B., Negrete, V., Davis, M. and Korsch, B., Gaps in doctor–patient communication: doctor–patient interaction analysis. Pediatric Research, 5 (1971), 298311.CrossRefGoogle Scholar

3 Strecher, V., Improving physician-patient interactions: a review. Patient Counselling and Health Education, 4 (1983), 129–36.CrossRefGoogle ScholarPubMed

4 Svarstad, B., The doctor–patient encounter: an observational study of communication and outcome. Unpublished doctoral dissertation, University of Wisconsin, Madison, 1974.Google Scholar

5 Bartlett, E., Grayson, M., Barker, R., Levine, D., Golden, A. and Libber, S., The effects of physician communications skills on patient satisfaction, recall, and adherence. Journal of Chronic Diseases, 37 (1984), 755–64.CrossRefGoogle ScholarPubMed

6 Linder-Pelz, S. and Struening, E., The multidimensionality of patient satisfaction with a clinic visit. Journal of Community Health, 10 (1985), 4254.CrossRefGoogle ScholarPubMed

7 Egbert, L., Battit, G., Welch, C. and Bartlett, M., Reduction of postoperative pain by encouragement and instruction of patients: a study of doctor–patient rapport. New England Journal of Medicine, 270 (1964), 825–27.CrossRefGoogle ScholarPubMed

8 Greenfield, S., Kaplan, S. and Ware, J., Expanding patient involvement in care. Annals of Internal Medicine, 102 (1985), 520–28.CrossRefGoogle ScholarPubMed

9 Starfield, B., Wray, C., Hess, K., Gross, R., Birk, P. and D'Lugoff, B., The influence of patient–practitioner agreement on outcome of care. American Journal of Public Health, 71 (1981), 127–32.CrossRefGoogle ScholarPubMed

10 Suchman, A. L. and Matthews, D. A., What makes the patient–doctor relationship therapeutic? Exploring the connexional dimension of medical care. Annals of Internal Medicine, 108 (1988) 125–30.CrossRefGoogle ScholarPubMed

11 Lowy, L., The implication of demographic trends as they affect the elderly. Journal of Geriatric Psychiatry, 19 (1986), 149–74.Google ScholarPubMed

12 Greene, M., Adelman, R., Charon, R. and Hoffman, S., Ageism in the medical encounter: an exploratory study of the doctor–elderly patient relationship. Language and Communication, 6 (1986), 113–24.CrossRefGoogle ScholarPubMed

13 Haug, M. and Ory, M., Issues in elderly patient–provider interactions. Research on Aging, 9 (1987), 344.CrossRefGoogle ScholarPubMed

14 Lawton, M., Research needs in understanding the physician–older patient relationship. In Haug, M. (ed) Elderly Patients and Their Doctors. Springer, New York, 1981.Google Scholar

15 Hooper, E., Comstock, L. and Goodwin, J., Patient characteristics that influence physician behavior. Medical Care, 20 (1982), 630–38.CrossRefGoogle ScholarPubMed

16 Adelson, R., Nasti, A., Spraflcin, J., Marinelli, R., Primavera, L. and Gorman, B., Behavioral ratings of health professionals' interactions with the geriatric patient. The Gerontologist, 22 (1982), 277–81.CrossRefGoogle ScholarPubMed

17 Coe, R., Prendergast, C. and Psathas, G., Strategies for obtaining compliance with medications regimens. Journal of the American Geriatrics Society, 32 (1984), 589–94.CrossRefGoogle ScholarPubMed

18 Rost, K., Personal communication, 1989.Google Scholar

19 Kalish, R., To be or not to be…old. Presentation at ‘Perceiving the Elderly’ Conference,Brooklyn College,New York,May 1985.Google Scholar

20 Wetle, T., Age as a risk factor for inadequate treatment. Journal of the American Medical Association, 258 (1987), 16.Google ScholarPubMed

21 Rees, T. S. and Duckert, L. G., Auditory and vestibular dysfunction in aging. In Hazzard, W., Andres, R., Blerman, E. and Blass, J. (eds) Principles of Geriatric Medicine and Gerontology. McGraw-Hill Inc., New York 1990, pp. 432–44.Google Scholar

22 Charatan, F. B., Sherman, F. T. and Libow, L. S., Geriatric psychiatry. In Libow, L. S. and Sherman, F. T. (eds) The Core Of Geriatric Medicine: A Guide for Students and Practitioners. The C. V. Mosby Co., St. Louis, 1981, pp. 5984.Google Scholar

23 Folstein, M., Foistein, S. and McHugh, P., Mini-mental state. Journal of Psychiatric Research, 12 (1975), 189–98.CrossRefGoogle ScholarPubMed

24 Coe, R. and Prendergast, C., Research note: The formation of coalitions: interaction strategies in triads. Sociology of Health and Illness, 7 (1985), 236–47.CrossRefGoogle Scholar

25 Rosow, I., Coalitions in geriatric medicine, In Haug, M. (ed) Elderly Patients and Their Doctors. Springer, New York, 1981.Google Scholar

26 Adelman, R., Greene, M., Menack, C. and Charon, R., The presence of a third person in the geriatric encounter: a descriptive study. Unpublished, 1990.Google Scholar

27 Adelman, R., Greene, M. and Charon, R., The physician–elderly patient–companion triad in the medical encounter: the development of a conceptual framework and research agenda. The Gerontologist, 27 (1987), 729–34.CrossRefGoogle ScholarPubMed

28 Butler, R., The tragedy of old age in America. Why Survive? Being Old in America. Harper Row, New York, 1975, chapter I.Google Scholar

29 Radecki, S., Kane, R., Solomon, D., Mendenhall, R. and Beck, J., Do physicians spend less time with older patients? Journal of the American Geriatrics Society, 36 (1988), 713–18.CrossRefGoogle ScholarPubMed

30 Rogers, E. and Bhowmik, D., Homophily–heterophily relational concepts for communication research. Public Opinion Qyarterly, 34 (1970) 523–38.CrossRefGoogle Scholar

31 Stewart, M., Patient characteristics which are related to the doctor–patient interaction. Family Practice, I (1983), 3036.Google Scholar

32 Greene, M., Hoffman, S., Charon, R. and Adelman, R., Psychosocial concerns in the medical encounter: a comparison of the interactions of doctors with their old and young patients. The Gerontologist, 27 (1987), 164–8.CrossRefGoogle ScholarPubMed

33 Armitage, K., Schneiderman, L. and Bass, R., Response of physicians to medical complaints in men and women. Journal of the American Medical Association, 241 (1979), 2186–7.CrossRefGoogle ScholarPubMed

34 Bernstein, B. and Kane, R., Physicians' attitudes toward female patients. Medical Care, 19 (1981), 600–8.CrossRefGoogle ScholarPubMed

35 Levy, D., White doctors and black patients: influence of race on the doctor–patient relationship. Pediatrics, 75 (1985), 639–43.Google ScholarPubMed

36 Eisenberg, J., Sociologic influences on decision-making by clinicians. Annals of Internal Medicine, 90 (1979), 957–64.CrossRefGoogle ScholarPubMed

37 Epstein, A., Taylor, W. and Seage, G., Effects of patients' socioeconomic status and physician training and practice on patient–doctor communication. American Journal of Medicine, 78 (1985), 101–6.CrossRefGoogle ScholarPubMed

38 Waitzkin, H., Doctor–patient communication: clinical implications of social scientific research. JAMA, 252 (1984), 2441–6.CrossRefGoogle ScholarPubMed

39 Szasz, T. and Hollender, M., A contribution to the philosophy of medicine: three basic models of doctor–patient relationship. Archives of Internal Medicine, 97 (1956), 585–92.CrossRefGoogle Scholar

40 Gray, M., Communicating with elderly people. In Pendelton, D. and Hassler, J. (eds) Doctor–Patient Communication. Academic Press, New York, 1983.Google Scholar

41 Speedling, E. and Rose, D., Building an effective doctor–patient relationship: from patient satisfaction to patient participation. Social Science and Medicine 21 (1985), 115–20.CrossRefGoogle ScholarPubMed

42 Steele, D., Blackwell, B., Gutman, M. and Jackson, T., The activated patient: dogma, dream, or desideratum? Patient Education and Counselling, 10 (1987), 323.CrossRefGoogle ScholarPubMed

43 Rodin, J., Ageing and health: effects pf the sense of control. Science, 233 (1986), 1271–6.CrossRefGoogle Scholar

44 Woodward, N. and Wallston, S., Age and health care beliefs: self-efficacy as a mediator of low desire for control. Psychology and Aging, 2 (1987), 38.CrossRefGoogle ScholarPubMed

45 Weisman, C. and Teitelbaum, M., Physician gender and the physicial–patient relationship: recent evidence and relevant questions. Social Science and Medicine, 20 (1985) 1119–27.CrossRefGoogle ScholarPubMed

46 Greene, M., Charon, R., Adelman, R. and Friedmann, E., Language and Behavior of Female and Male Physicians in the Medical Encounter. American Public Health Association, New Orleans, 1987.Google Scholar

47 Clute, K., The General Practitioner. University of Toronto Press, Canada, 1963.CrossRefGoogle Scholar

48 Stolley, P., Becker, M. H., Lasagna, L., McEzilla, G. D. and Sloane, L. M., The relationship between physician characteristics and prescribing appropriateness. Medical Care, 10 (1972), 1728.CrossRefGoogle ScholarPubMed

49 Braithwaite, V., Old age stereotypes: reconciling contradictions. Journal of Gerontology, 41 (1986), 353–60.CrossRefGoogle ScholarPubMed

50 Kosberg, J., The importance of attitudes on the interaction between health care providers and geriatric populations. Interdisciplinary Topics in Gerontology, 17 (1983), 132–43.CrossRefGoogle Scholar

51 Retchin, S. and Brown, B., The quality of ambulatory care in Medicare health maintenance organizations. American Journal of Public Health, 80 (1990), 411–15.CrossRefGoogle ScholarPubMed

52 Stein, S., Linn, M., Edeistein, J. and Stein, E., Elderly patients' satisfaction with care under HMO versus private systems. Southern Medical Journal, 82 (1989), 38.CrossRefGoogle ScholarPubMed

53 Eisenthal, S. and Lazare, A., Evaluation of the initial interview in a walk-in clinic. Journal of Nervous and Mental Disease, 162 (1976), 169–76.CrossRefGoogle Scholar

54 Davis, M., Variations in patients' compliance with doctors' advise: an empirical analysis of patterns of communication. American Journal of Public Health, 58 (1968), 274–88.CrossRefGoogle Scholar

55 Heszen, Klemens I. and Lapinska, E., Doctor–patient interaction, patients' health behavior and effects of treatment. Social Science and Medicine, 19 (1984), 918.CrossRefGoogle Scholar

56 Francis, V., Korsch, B. M. and Morris, M.J., Gaps in doctor–patient communication: patients' response to medical advice. New England Journal of Medicine, 280 (1969), 535–40.CrossRefGoogle ScholarPubMed

57 Ware, J. E. Jr, and Davis, A. R., Behavioral consequences of consumer dissatisfaction with medical care. Evaluation and Programming Planning, 6 (1983), 291–7.CrossRefGoogle ScholarPubMed

58 Kasteler, J., Kane, R. L., Olsen, D. M. and Thetford, C., Issues underlying the prevalence of ‘doctor-shopping’ behavior. Journal of Health and Social Behavior, 17 (1976), 328–39.CrossRefGoogle ScholarPubMed

59 Mirowsky, J. and Ross, C. E., Patient satisfaction and visiting the doctor: a self- regulating system. Social Science and Medicine, 17 (1983), 1353–61.CrossRefGoogle ScholarPubMed

60 Davies, A. R. and Ware, J. E. Jr, Brook, R. H., Peterson, J. R. and Newhouse, J. P., Consumer acceptance of prepaid and fee-for-service medical care: results from a randomized controlled trial. Health Services Research, 21 (1986), 429–52.Google ScholarPubMed

61 Anderson, L., Rakowski, W. and Hickey, T., Satisfaction with clinical encounters among residents and geriatric patients. Journal of Medical Education, 63 (1988), 447–55.Google ScholarPubMed

62 Rosenbloom, A., Essential factors in the care of elderly patients. Journal of the American Optometric Association, 59 (1988), 774–9.Google ScholarPubMed

63 German, P., Compliance and chronic disease. Hypertension II (Suppl. II): II56, 1988.Google Scholar

64 Linn, M., Linn, B. and Stein, S., Satisfaction with ambulatory care and compliance in older patients. Medical Care, 20 (1982), 606–14.CrossRefGoogle ScholarPubMed

65 Greenfield, S., Kaplan, S., Ware, J., Martin, E. and Frank, H., Expanded Patient Involvement in Medical Care: Efects on blood sugar. Society for Research in Primary Care Internal Medicine, 1986.Google Scholar

66 Cohen-Cole, S., Behavior in the Medical Interview and Satisfaction of Physicians. Society of General Internal Medicine, Arlington, Virginia, 1988.Google Scholar

67 Shore, B. and Franks, P., Physician satisfaction with patient encounters: reliability and validity of an encounter-specific questionnaire. Medical Care, 24 (1986), 580–89.CrossRefGoogle ScholarPubMed

68 Suchman, A. L., Physician Satisfaction: Association with Patient Characteristics. Society of General Internal Medicine, Arlington, Virginia, 1988.Google Scholar

69 Greene, M., Adelman, R. and Charon, R., The physician–elderly patient relationship: an examination of the language and behavior of doctors with their elderly patients. Final report submitted to AARP Andrus Foundation, 1987.Google Scholar

70 Charon, R., Adelman, R. and Greene, M. Linguistic instruments and the medical encounter: can we capture content, context, and meaning? International Conference on Doctor–Patient Communication, London, Ontario, Canada, 1986.Google Scholar

71 Bales, R. F., Interaction Process Analysis. Addison-Wesley, Cambridge, Mass., 1950.Google Scholar

72 Greene, M., The physician–patient relationship in three medical primary care settings. Doctoral dissertation, unpublished. Columbia University School of Public Health, 1981.Google Scholar

73 Roter, D. L., Patient participation in the patient-provider interaction: the effects of patient question-asking on the quality of interaction, satisfaction, and compliance. Health Education Monograph, 5 (1977), 281315.CrossRefGoogle ScholarPubMed

74 Roter, D. L. and Hall, J. A., Studies of physician–patient interactions. Annual Review of Public Health, 10 (1989), 163–80.CrossRefGoogle Scholar

75 Byrne, P. S. and Long, B., Doctors Talking to Patients. HMSO, London, 1976.Google Scholar

76 Frankel, R. M., The laying on of hands: aspects of the organization of gaze, touch, and talk in a medical encounter. In Fisher, S. and Todd, A. D. (eds) The Social Organization of Doctor–Patient Communication. Center for Applied Linguistics, Washington, D.C., 1983.Google Scholar

77 Labov, W. and Fanshel, D., Therapeutic Discourse: Psychotherapy as Conversation. Academic Press, New York, 1977.Google Scholar

78 Mishler, E. G., The Discourse of Medicine: Dialectics of Medical Interviews. Ablex Publishing Corp., Norwood, New Jersey, 1984.Google Scholar

79 Greene, M., Adelman, R., Charon, R. and Friedmann, E., Decision-making in the Medical Encounter. Gerontological Society of America, Minneapolis, Minnesota, 1989.Google Scholar

80 Ben-Sira, Z., Affective and instrumental components in the physician–patient relationship. Journal of Health and Social Behavior, 21 (1980), 170–80.CrossRefGoogle ScholarPubMed

81 Greene, M., Adelman, R., Charon, R. and Friedmann, E., Concordance between physicians and their older and younger patients in the primary care medical encounter. The Gerontologist, 29 (1989), 808–13.CrossRefGoogle ScholarPubMed