An impressive body of literature exists which suggests that physicianpatient rapport is essential to effective medical care delivery. This article presents a summary of the findings to date of an ongoing research project designed to investigate patient satisfaction with the interpersonal aspects of medical care. The focus is on patients' perceptions of the rapport they have with their physicians and on the characteristics of physicians that contribute to the establishment of rapport with patients. The results indicate two factors that contribute significantly to patient satisfaction with the physician-patient relationship: (a) the ability of the physician to understand the emotions of others apparent in their body movement and posture cues and (b) the physician's skill at detecting emotional messages to others through nonverbal channels of facial expression and voice tone. Implications for the training of primary care physicians are discussed. In 1974 we began a collaborative research effort, bringing together our differing perspectives (from the fields of social psychology and medicine) to an exploration of this question: If a physician is technically competent, does it matter if he or she is empathic, or caring, or kind in the process? In other words, is rapport with patients, such as that attributed to the old-time physician, still necessary, now that medicine is performing miracles of treatment, and health care is one of the nation's largest industries? We found in the medical, public health, and social-psychological literature strong indications of the critical importance of supplementing the technical knowledge and expertise of modern-day physicians with effective interpersonal treatment. The literature was replete with evidence that the process by which healing takes place is, in part, an interpersonal one. The importance of physician-patient rapport has long been recognized by physicians (cf. Hippocrates, 1923 edition; Osier, 1904). However, interpersonal factors in patient care are rarely emphasized in modern medicine, perhaps because, as a result of the fragmented, specialized technical advancements of modern medicine, attention to such matters seems superfluous and inefficient. Nevertheless, over the past two decades, empirical evidence has been accumulating which suggests that physical healing may be a process that depends to a large extent on effective interpersonal communication between physician and patient, that is, on physician-patient rapport. Experimental research has suggested that the interpersonal quality of the physician-patient relationship can actually influence the patient's course of recovery. In a study of surgical patients, Egbert, Battit, Welch, and Bartlett (1964) demonstrated that supportive communication between physician and patient can decrease the patient's anxiety and his or her need for postoperative pain medication and can also result in an earlier discharge from the hospital. The communication of caring, concern, and realistic positive expectations is especially important for seriously ill patients because
Read full abstract
Jan 1, 2004
Lorrie Ippensen + 1
Open Access
