Patient-Provider Communication Falls Short of Patient Expectation

In In The News by Barbara Jacoby

By: Sara Heath


Forty-five percent of patients said they wish patient-provider communications included chats about lifestyle health and motivating factors for wellness.

Although patient-provider communication is an essential aspect of the primary care visit, expectations aren’t quite reality, according to data from Samueli Integrative Health Programs, a non-profit healthcare advocacy group.

A survey of 2,000 adult patients conducted online by Harris Poll revealed that patients want to discuss more than their physical health during a primary care encounter. Forty-five percent of patients said they wish their PCPs asked more about why patients want to be healthy.

Ninety-two percent of respondents acknowledged that health is more than just their symptoms. Fifty-nine percent agreed that health also includes being happy, 56 percent said it includes being calm and relaxed, and 53 percent said it includes the ability to live independently.

However, those expectations aren’t being met, said Wayne Jonas, MD, executive director of Samueli Integrative Health Programs.

“Patients see their health as much more than just their physical symptoms, yet doctors aren’t talking to their patients about important factors that influence their health,” Jonas explained. “A whole-person, integrative approach to health and well-being allows patients to get to the root of their health conditions, but we haven’t yet made this approach a priority in treating patients.”

Fifty-two percent of respondents said they don’t talk to their providers about the factors that influence health. Instead, a majority of patients (74 percent) said their providers focus on elements of physical health such as symptoms, lab results, and treatments.

Far fewer patients and providers discuss exercise (51 percent), diet (44 percent), and sleep patterns (40 percent). And even fewer patients discuss elements of emotional health. Thirty-six percent of patients said they have discussed mental health with their providers, despite the fact that one in five patients with a chronic illness also have a mental illness.

Only 10 percent of patients have discussed spiritual health with providers.

These trends bother some patients more than others, the survey revealed. Younger patients ages 18 to 44 tend to want a more holistic approach to patient-provider communications compared to older patients over the age of 45.

For example, younger patients are more likely than older patients to say they don’t discuss more than physical health issues. Fifty-seven percent of younger patients said this compared to only 48 percent of older patients.

Younger patients are also more apt to say they wish they discussed those things with providers than older patients – 55 percent compared to 38 percent, respectively.

Additionally, 63 percent of younger patients said they want to discuss non-drug treatments while only 46 percent of older patients said the same.

“The current model of medicine focuses on providing pills and procedures for addressing physical symptoms and prescribing quick fixes,” Jonas noted. “But younger patients want more. They are looking for options that fit their lifestyle and personal needs. This generational shift proves that more and more patients will be seeking out ways to address the underlying causes of health.”

There are also geographic differences in approaches to person-centered health, the survey showed. People living in the Northeast are more likely to rate their health as excellent (24 percent) compared to those living in the South (18 percent) and the Midwest (17 percent).

Northeasterners also tend to discuss lifestyle factors with primary care providers (27 percent). This compares to only 20 percent of patients living in the South, 17 percent in the Midwest, and 18 percent in the West.

Nevertheless, patients remain optimistic about their health. Seventy-six percent of all patients rated their health as excellent, and 86 percent said they think they have a great amount of control over their own health. Eighty-four percent of patients said their health goals align with their life goals.

To maintain this positive view of patient health, however, providers may consider a more holistic approach to healthcare and patient-provider communication. Just as patients assert that health is more than just their disease condition, industry experts are also pointing to lifestyle as major determinants of health.

“We know from past research that some 80 percent of health and healing are influenced by behavioral and social determinants of health – factors that affect a patient outside of their medical treatment,” Jonas said. “Health starts with the person, not the disease. And we as physicians should be asking ‘What matters?’ instead of just ‘What’s the matter?’ This is essential for patient-centered care.”