How Primary Care Physicians Elicit Sensitive Health Information From Patients: Describing Access to Psychosocial Information

Abstract

Multiple communication models describe factors that influence disclosure of sensitive health information. However, these models do not address the receiver's perspective of health-related information, nor do they address how the receiver promotes disclosure. In the primary care chronic disease visit, the patient (sender) must disclose sensitive health-related psychosocial information to the primary care physician (PCP) (receiver) for the PCP to understand potential barriers to care (e.g., financial strain) and make treatment decisions (e.g., referral to social work). A vital gap exists in understanding how PCPs perceive that patients disclose. We conducted individual, semi-structured interviews (n = 17) to understand PCPs' perceptions of patient disclosure of sensitive, psychosocial information in the clinical visit. PCPs facilitate patient disclosure by (a) building and maintaining rapport and (b) nurturing the patient-provider relationship. This article describes PCPs' perceptions of how they access psychosocial information which is vital to inform clinical decisions that facilitate personalized care.