Preferences for medical collaboration: patient-physician congruence and patient outcomes.

Patient participation in medical care and in decision-making is generally viewed as a precursor to positive health outcomes. Patient participation is not always possible or desirable, however, and not all patients want to take an active part in their own medical care. This study examines the degree to which physician-patient congruence in preference for patient involvement is related to self-reported satisfaction, adherence, and health. Results indicate that when patients and their doctors share similar beliefs about patient participation, patient outcomes tend to be more positive, with highest satisfaction found in cases in which both patient and physician desire more patient involvement.

Physician facilitation of patient involvement in care: correspondence between patient and observer reports.

The authors surveyed 128 patients with type 2 diabetes mellitus (1) to evaluate the congruence between patients' and observers' perceptions of physicians' facilitation of patients' involvement in care and (2) to identify which physician behaviors were most closely related to patients' perceptions that their doctors encouraged them to be involved in their care. The patients reported the degree to which they perceived that their physicians encouraged their involvement in the medical care process. Raters blind to the study hypotheses coded audiotapes of the physician-patient interactions. Pearson's r and simultaneous multiple regression used to address the study questions indicated a small to moderate, but statistically significant, association between patients' perceptions and observers' reports concerning the physicians' levels of facilitation. Open-ended questions, responding to patient questions, and offering fewer alternatives were all associated with the patients' positive reports of physician facilitation.