Structure of the association between patient and physician evaluations of the level of physician explanations

Given that physicians must subjectively judge their level of explanation in actual practice, and that explanations perceived to be inadequate can lead to patients ceasing to use a particular doctor or to the practice of doctor-shopping behavior, physicians need to accurately evaluate patients' perceptions of the sufficiency of physicians' explanations. We studied the association between patient and physician evaluations of the level of physician explanations. The subjects were 630 physician-patient pairs in Japan. Path analysis was used to reveal the structure of the association between patient and physician evaluations. From a random selection of 190 physicians and 950 patients, 126 physicians and 630 patients returned questionnaires (response rate for both, 66.3%). We found the following, (1) There was no direct association between physician and patient evaluations of the sufficiency of a physician's explanation, and (2) "Improvement in health and anxiety level", "courtesy", and "being rushed" had the strongest influences on patient understanding and recognition of the sufficiency of a physician's explanation. In order to promote patient understanding and to provide patients with satisfactory explanations, it is important for physicians to alleviate patient anxiety, to be courteous, and to not rush patients while seeing them. Although these findings are useful for improving doctor-patient communication, some are not consistent with previous findings, more research will be necessary to add to these present findings.