'Thoroughness' Trait Most Desired in a Physician

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Study finds patients agree on ideal physician behaviors

ROCHESTER, Minn. -- A study of Mayo Clinic patients has found seven

behaviors define the 'ideal' physician and supports an Institute of

Medicine recommendation that quality medical care should include a

patient-centered approach.

The Mayo Clinic-led study was designed to develop a comprehensive set

of ideal physician behaviors. Telephone interviews were conducted in

2001 and 2002 with 192 patients who were seen in 14 medical

specialties of Mayo Clinic in sdale, Ariz., and Rochester.

Published in the March issue of Mayo Clinic Proceedings, the article

was based on transcripts of patients detailing their best and worst

experiences with a Mayo Clinic physician. From the transcripts, study

authors identified seven behaviors that describe the ideal physician -

- confident, empathetic, humane, personal, forthright, respectful and

thorough.

Conversely, patients who described a " worst physician " experience

focused on traits reflecting opposites of desired physician

behaviors, especially perceived insensitive or disrespectful

behavior.

The study suggests that training new and practicing physicians about

interpersonal skills could have far-reaching effects for patients.

The quality of a patient's relationship with a physician can affect

not only a patient's emotional responses, but also behavioral and

medical outcomes such as compliance and recovery.

An editorial in the same issue expands on the patient-physician

relationship, saying health institutions ought to follow the

recommendations of the Institute of Medicine to improve quality by

fostering a patient-centeredness approach to medicine.

Li, M.D., Ph.D., Mayo Clinic Division of Allergic Diseases,

writes in an editorial that health care can't meet a standard of

quality if the patient-physician interaction is hurried,

disrespectful, cold or callous. Dr. Li has been involved with

developing programs and curricula for teaching new and practicing

physicians at Mayo Clinic about how to strengthen their interactions

with patients. Mayo's structure of focusing on the patient also helps

nurture strong relationships between physician and patient, he says.

" A physician who pays personal attention to the patient, who is

respectful, compassionate and competent, that's what every patient

wants, " Dr. Li says. " It's really the duty and obligation of the

medical community to design a health care system so that physicians

are best able to exhibit those qualities for the good of the patient

during the clinical encounter. "

Dr. Li notes the seven behavioral traits identified by researchers as

ideal for physicians can be taught in various settings, such as

having medical residents witness positive interactions which they can

model.

Of the seven behavior traits, " thorough " was named most often by

patients. Patients can sense if a physician is rushed or preoccupied,

the study's authors say, just as they can sense a physician's genuine

interest.

" If patients have opportunities to tell their stories, to be asked

questions and have the physician verbalize understanding of what's

been shared, it leaves them feeling like they were heard, " Dr. Li

says. " This leaves them with the impression that the physician was

thorough. " In their interviews about physician behavior, patients

rarely commented on a physician's technical skill. This doesn't

suggest technical skill is less important than interpersonal skill,

the authors say, but rather more difficult for patients to judge.

Authors of the study include Neeli Bendapudi, Ph.D., Fisher College

of Business, Ohio State University; Leonard Berry, Ph.D., from the

Mays Business School, TAMU System Health Science Center, Texas A & M

University; Frey, M.D., Department of Family Medicine, Mayo

Clinic in sdale; Janet Parish, Ph.D., Mays Business

School, Texas A & M University; and Rayburn, M.D., Department

of Obstetrics and Gynecology, Texas A & M University Health Science

Center and & White Clinic.