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Today's doctors are trained to take a more "patient-centered" approach toward healthcare. That means educating patients about their conditions, encouraging questions and collaboration, discussing how the condition affects the patient emotionally, and involving patients in treatment decisions.

Some patients prefer that style and respond very well to it. But new research at the University of Iowa suggests that it doesn't work for everybody. In fact, some patients are significantly less likely to follow doctors' orders and feel satisfied with their care when physicians take the patient-centered approach.

According to the UI study, recently published in the Annals of Behavioral Medicine, patients are most satisfied with care and most likely to follow treatment plans -- like taking medication or making diet changes -- if they see a doctor whose attitudes toward patient-physician roles are in line with their own.

But some patients, especially older patients, prefer a doctor with a more traditional "doctor-centered" or "paternalistic" style, someone who spends less time explaining a condition and seeks little patient input when it comes to treatment decisions. The study showed that when those patients are matched with patient-centered doctors who want them to take a highly active role, they're less likely to follow treatment recommendations or feel satisfied with their care.

"There's really a sizable subset of patients with whom the patient-centered approach is going to backfire," said Alan Christensen, professor of psychology in the UI College of Liberal Arts and Sciences, who collaborated with three colleagues on the study. "There are patients who strongly believe it's the physician's job to make decisions. If those people are matched with a physician who wants patients to be more engaged, the physician could end up putting too much responsibility on the patient's shoulders and not giving them enough direction. So they leave the
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Contact: Nicole Riehl
nicole-riehl@uiowa.edu
319-384-0070
University of Iowa
13-Aug-2007