The impact of patient-centered communication on patients' decision making and evaluations of physicians: a randomized study using video vignettes

Patient Educ Couns. 2011 Sep;84(3):386-92. doi: 10.1016/j.pec.2011.04.023. Epub 2011 May 19.


Objective: To assess the impact of patient-centered communication (PCC) behaviors on patients' evaluations of physicians and acceptance of clinical recommendations.

Methods: We randomized 248 patients to view video-recorded, standardized vignettes, depicting a cardiologist using a high vs. low degree of PCC while recommending bypass surgery to a patient with angina and 3-vessel coronary artery disease. We compared patients' ratings of the physician and their decision making in response to the physician's recommendation, for high vs. low PCC vignettes.

Results: Patients viewing high PCC vignettes rated the video physician more favorably overall (3.01 vs. 2.12, p<0.001) and as more competent (3.22 vs. 2.66, p<0.001) and trustworthy (2.93 vs. 2.28, p<0.001) than those viewing the low PCC version (0-4 range for all scales). Patients viewing the high PCC version more frequently said they would undergo bypass surgery (96% vs. 74%, p<0.001) if they were the patient in the video.

Conclusion: Patients expressed greater confidence in physicians who used more PCC behaviors, and greater willingness to accept an evidence-based recommendation.

Practice implications: PCC may make physicians more effective in the delivery of evidence-based care.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Cardiology
  • Chi-Square Distribution
  • Communication*
  • Decision Making*
  • Female
  • Humans
  • Interpersonal Relations
  • Male
  • Middle Aged
  • Patient-Centered Care*
  • Physician-Patient Relations*
  • Physicians / psychology*
  • Physicians / statistics & numerical data
  • Statistics as Topic
  • United States
  • Videotape Recording