Examining the relationship between clinician communication and patient participatory behaviors in cardiology encounters

Examine the association of coder ratings of cardiologist behaviors and global scores of cardiologist communication style with patient participation in clinic encounters. We coded transcripts of clinic encounters for patient participatory behaviors: asking questions, assertive statements, and expressing negative emotions; clinician behavior counts: reflective statements, open-ended questions, empathic statements, and eliciting questions. We used general linear regression models to examine associations of mean number of patient participatory behaviors with clinician behaviors. Our sample included 161 patients of 40 cardiologists. Patient female gender was associated with on average 2.1 (CI: 0.06, 4.1; p = 0.04) more patient participatory behaviors. In an adjusted model, clinician reflective statements were associated with on average 0.3 (CI: 0.04, 0.4; p = 0.02) more patient participatory behaviors. A clinician making at least one empathic statement was associated with on average 3.7 (CI: 0.2, 7.1; p = 0.04) more patient participatory behaviors. These results demonstrate that some individual clinician behaviors are associated with higher patient participation in cardiology encounters. Clinician reflective and empathic statements may be important targets in communication training to increase patient participation. Communication Studies. •Cardiologist empathic statements are associated with greater patient participation.•Cardiologist reflections are also associated with greater participation.•Patient female gender is associated with greater participation in cardiology visits.