Strengthening the Patient-Provider Relationship in a Changing Health Care Environment

An RWJF National Program

Dates of Program: April 1996 through September 2004

Field of Work: Research on the effect of managed care on the doctor/patient relationship.

Problem Synopsis: When the American health care system was transformed by market forces seeking to contain costs in the mid-1990s, managed care emerged as a possible solution. However, there was concern that there would be a negative effect on the patient-provider relationship. For example, some managed care strategies might create incentives to provide less care than needed to particular patient populations and steer patients away from their usual providers and care settings in the name of efficiency and cost-cutting.

Synopsis of the Work: Strengthening the Patient-Provider Relationship in a Changing Health Care Environment examined the relationship between patients and their health care providers within managed care, laid the groundwork for a broader discussion of managed care's impact on the patient-provider relationship and patient care.

Key Findings

  • According to the national program director, Bernard Lo, MD, these were the program's key findings about the patient-provider relationship:

    • Patients who trust their physicians have better clinical outcomes.
    • When patients trust their physicians, unmet expectations are rare.
    • Patients use information from the Internet within the doctor-patient relationship rather than as a substitute for it.
    • Patients need to learn to better evaluate the quality of health-related information on the Internet.
    • Not all patients prefer the patient-oriented communication styles (which incorporate the patient's expectations, feelings and illness beliefs) that are taught in medical schools and residency programs.

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