Patients Becoming more Empowered, New Study Finds


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There has been a fundamental shift in the patient-physician relationship away from an authoritarian and paternalistic model and toward partnership and team based approaches, according to a new international study of patients' and physicians' perceptions.

Patients are significantly more confident and empowered than they were ten years ago. They possess high confidence in physicians but also demonstrate higher expectations for ideal physician performance and higher expectations for improvement. Physician confidence in patient self-management is more modest.

The results of the study were announced today (Thursday) by Dr Mike Magee, Senior Fellow in the Humanities to the World Medical Association and Director of the Pfizer Medical Humanities Initiative, addressing the WMA's annual General Assembly meeting in Helsinki.

The study is based on 3,707 interviews last year with general practitioners and patients in six countries in four continents - the United States, United Kingdom, Canada, Germany, South Africa and Japan. The study captured patient and physician opinions of physician performence in five dimensions of humanistic care and five dimensions of accessibility to care.

Among the findings are:

  • The patient-physician relationship ranks second in importance to family relationships in all countries studied;
  • Physicians are the leading source of health information, the most trusted source, and the source most likely to instigate positive behavioral change in patients in all countries studied;
  • All countries agree that authoritarian paternalistic relationships between physicians and patients are relatively uncommon today. These relationships are being replaced by mutual partnerships or advisor models;
  • Patients and physicians in all countries foresee future movement toward partnership and team based models;
  • Compared to 10 years ago, most patients in all countries believe they ask more questions, make more choices, actively evaluate benefit and risk, and take better care of their own health;
  • Patients' confidence in managing their own health is very high in all countries except Japan. Physician confidence in patients' self-management is lower than patients scoring in five of the six countries;
  • In general, patients rate issues such as compassion, trust, understanding, patience and listening higher than access to physicians;
  • Physicians in all countries rate their performance on issues such as trust higher than do patients. In contrast, physicians in the United Kingdom and Germany rate their ideal access performance lower than the patients' expectation for ideal access performance;

Commenting on the findings, Dr Magee said:

"The patient-physician relationship is part of the critical underpinning of stable societies. In addition to diagnosis, treatment and prevention, the relationship reinforces family linkages, processes citizens' daily fears and worries, and helps reinforce long term confidence and associated willingness to invest in the future. As such, health care system investment delivers an enormous value beyond nuts and bolts healthcare.

Physicians' ability to measure up to patient expectations for humanistic and accessible care will largely define the physician's future effectiveness as a health care leader and will determine how the patient-physician relationship will influence the well being of the individual, family, community and society in the future."

A copy of the report and tables is attached.

Note to editors:
Patients and physicians were simultaneously studied in six countries using nationally representative telephone surveys between July 22, 2002 and October 13, 2002. 2506 interviews were conducted on patients (63% response rate) and 1201 interviews were conducted on physicians (58% response rate) using a random digit dialing (RDD) methodology.