Patient and physician attitudes in the health care context: attitudinal symmetry predicts patient satisfaction and adherence

There is increasing interest in the role that patient and physician health-related attitudes may play in predicting patient outcomes. This study examined the similarity of the attitudes held by patients and their physicians about the patient role in health care delivery and its relationship to patient outcomes. Participants were 16 primary care physicians from a single academic medical center and 146 patients who had been seen by their respective physician at least twice during the prior 6 months. Physicians and patients completed two measures reflecting healthcare-related attitudes: the Multidimensional Health Locus of Control questionnaire and the Patient-Practitioner Orientation Scale (PPOS). Patients also completed measures of satisfaction and adherence. Analyses were conducted using hierarchical linear modeling with patients clustered within physicians. Degree of symmetry on internal health locus of control was positively associated with both patient adherence, F(2, 131) = 3.75, p = .03, and satisfaction, F(2, 133) = 7.16, p = .01. Degree of similarity on the Information/Power Sharing subscale of the PPOS was not positively associated with adherence or satisfaction. These data suggest that patients who are more similar in attitude to their physicians as indicated by internal health locus of control scores (but not PPOS scores) are more satisfied with their medical care and more adherent with treatment recommendations than patients who are less internally focused than their physicians.