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Doctors assume their beliefs match patients’

PENN STATE / TEXAS A&M (US)—American physicians are often poor judges of their patients’ health beliefs, a new study shows.

Physicians’ understanding improves, however, with increases in patient involvement, such as asking questions, expressing concerns, and stating their beliefs and preferences for care.

An analysis of how patients’ health beliefs differ from their physicians’ perception of these beliefs was published online in the Journal of General Internal Medicine.

The study’s 207 physician-patient consultations were audio recorded and, after the consultations, both physicians and patients completed a measure of beliefs about the cause, meaning, treatment, and control of the patient’s health condition.

Physicians also completed a survey of how they thought the patient responded.

Researchers found that physicians generally did not have a good understanding of patients’ health beliefs, but their understanding was significantly better when patients more actively participated in the consultation.

However, in the majority of areas, doctors actually thought that their patients’ beliefs were similar to theirs.

“If physicians had a better understanding of their patients’ beliefs about health, they could address any misconceptions or differences of opinion they had with the patient regarding the nature, severity and treatment of their illnesses, as well as make treatment recommendations better suited to the patient’s life circumstances,” says Richard Street, a Texas A&M University communication professor.

“Encouraging the patient to be more involved in the consultation by expressing their beliefs and concerns is one way physicians can gain this understanding.”

The study also showed that physicians were poorer judges of beliefs about control when the patient was of a different race—such as African-American patients’ preferences to be partners in their care or Hispanic patients’ understanding of a particular condition. In some cases, understanding was better when physicians and patient were of the same race or ethnicity.

“When doctors take time to listen to what the patient has to say, they can get a wealth of information about the lens through which patients make sense of their health,” says Paul Haidet, director of medical education research at Penn State. “This can help them be better doctors.”

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