Factors Influencing Physicians’ Patient-Centered Communication Behavior in Medical Encounters

Main Article Content

Rezaul Karim
Md.Ibrahim Rahman Rume
Muhammad Zakaria


This study examines the factors associated with physicians’ patient-centered communication behavior in medical consultation in primary care settings in the Chittagong Hill Tracts (CHT) area of Bangladesh. A cross-sectional study was conducted among the patients (N = 850) who visited the physician in six district/Upazila hospitals. A structured and facilitator-administered questionnaire was used to collect data. The independent-samples t-test, Pearson correlation and the one-way between-groups analysis of variance (ANOVA) were conducted to find the relationship between independent variables and the outcome variable. Linear regression analyses were run to determine the factors influencing physicians’ patient-centered communication behavior in primary medical consultations. Data were analyzed using IBM SPSS version 24.0. This study explored that, patients’ age, being the Bengali, patients’ perception of the severity of the condition, pre-plan about the content of medical encounter, the ambiance of physicians’ room, and appointment length were positively associated with facilitative patient-centered communication behavior from the physicians. Besides, patients’ active participation, for example, seeking more information about their physical condition to the physician and participating in making decisions about the health problems were also resulted in effective patient-centered communication behavior. This study suggests providing physicians with adequate training for enhancing patient-centered skills and ensuring patients receive high-quality healthcare, regardless of inequality in patients’ socioeconomic status.

Article Details



Ahmed, R. (2012). Interpersonal health communication an ecological perspective. The handbook of global health communication, 26, 144.

Ashton, C. M., Haidet, P., Paterniti, D. A., Collins, T. C., Gordon, H. S., O'Malley, K., & Street, Jr, R. L. (2003). Racial and ethnic disparities in the use of health services: Bias, preferences, or poor communication? Journal of General Internal Medicine, 18(2), 146-152.

Beckman, H. B., & Frankel, R. M. (1984). The effect of physician behavior on the collection of data. Annals of Internal Medicine, 101(5), 692-696.

Brown, J. B., Stewart, M., & Ryan, B. L. (2003). Outcomes of patient-provider interaction. In The Routledge Handbook of Health Communication (pp. 155-176). Routledge.

Cooper, L. A., Roter, D. L., Johnson, R. L., Ford, D. E., Steinwachs, D. M., & Powe, N. R. (2003). Patient-centered communication, ratings of care, and concordance of patient and physician race. Annals of Internal Medicine, 139(11), 907-915.

DeVito, J. A. (2013). The interpersonal communication book (13th ed.). Boston, MA: Pearson.

Dugdale, D. C., Epstein, R., & Pantilat, S. Z. (1999). Time and the patient-physician relationship. Journal of General Internal Medicine, 14(Suppl 1), S34–S40.

Epstein, R. M., & Street Jr, R. L. (2007). Patient-centered communication in cancer care: promoting healing and reducing suffering. Bethesda, MD: National Cancer Institute/National Institutes of Health Publication. Available online: https://healthcaredelivery.cancer.gov/pcc/monograph.html

Fox, S. A., & Stein, J. A. (1991). The effect of physician-patient communication on mammography utilization by different ethnic groups. Medical Care, 1065-1082.

Gordon, H. S., & Street, R. L. (2016). How physicians, patients, and observers compare on the use of qualitative and quantitative measures of physician–patient communication. Evaluation & the Health Professions, 39(4), 496-511.

Gupta, N., & Carr, N. T. (2008). Understanding the patient-physician interaction: potential for reducing health disparities. Journal of Applied Social Science, 2(2), 54-65.

Howie, J. G., Porter, A. M., Heaney, D. J., & Hopton, J. L. (1991). Long to short consultation ratio: A proxy measure of quality of care for general practice. British Journal of General Practice, 41(343), 48-54.

Kaplan, S. H., Gandek, B., Greenfield, S., Rogers, W., & Ware, J. E. (1995). Patient and visit characteristics related to physicians' participatory decision-making style: Results from the Medical Outcomes Study. Medical Care, 1176-1187.

Kaplan, S. H., Greenfield, S., Gandek, B., Rogers, W. H., & Ware, J. E. (1996). Characteristics of physicians with participatory decision-making styles. Annals of Internal Medicine, 124(5), 497-504.

Lurie, N., Margolis, K. L., McGovern, P. G., Mink, P. J., & Slater, J. S. (1997). Why do patients of female physicians have higher rates of breast and cervical cancer screening? Journal of General Internal Medicine, 12(1), 34-43.

Marvel, M. K., Epstein, R. M., Flowers, K., & Beckman, H. B. (1999). Soliciting the patient's agenda: Have we improved? Jama, 281(3), 283-287.

Matusitz, J., & Spear, J. (2014). Effective doctor–patient communication: An updated examination. Social Work in Public Health, 29(3), 252-266.

Ong, L. M., De Haes, J. C., Hoos, A. M., & Lammes, F. B. (1995). Doctor-patient communication: A review of the literature. Social Science & Medicine, 40(7), 903-918.

Rao, J. K., Anderson, L. A., Inui, T. S., & Frankel, R. M. (2007). Communication interventions make a difference in conversations between physicians and patients: A systematic review of the evidence. Medical Care, 340-349.

Richard, P., Ferguson, C., Lara, A. S., Leonard, J., & Younis, M. (2014). Disparities in physician-patient communication by obesity status. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 51, 0046958014557012.

Roter, D. (2000). The enduring and evolving nature of the patient–physician relationship. Patient Education and Counseling, 39(1), 5-15.

Roter, D. L., Hall, J. A., & Aoki, Y. (2002). Physician gender effects in medical communication: A meta-analytic review. Jama, 288(6), 756-764.

Roter, D. L., Stewart, M., Putnam, S. M., Lipkin, M., Stiles, W., & Inui, T. S. (1997). Communication patterns of primary care physicians. Jama, 277(4), 350-356.

Sampson, R., O’Rourke, J., Hendry, R., Heaney, D., Holden, S., Thain, A., & MacVicar, R. (2013). Sharing control of appointment length with patients in general practice: a qualitative study British Journal of General Practice, 63(608), e185-e191.

Street, Jr, R. L., Gordon, H. S., Ward, M. M., Krupat, E., & Kravitz, R. L. (2005). Patient participation in medical consultations: why some patients are more involved than others. Medical Care, 960-969.

Uddin, E. (2015). Ethnic disparity in family socioeconomic status in Bangladesh: Implication for family welfare policy practice. Global Social Welfare, 2(1), 29-38.

Wachira, J., Middlestadt, S., Reece, M., Peng, C. Y. J., & Braitstein, P. (2013). Psychometric assessment of a physician-patient communication behaviors scale: The perspective of adult HIV patients in Kenya. AIDS research and treatment, 2013.

Weisman, C. S., & Teitelbaum, M. A. (1989). Women and health care communication. Patient Education and Counseling, 13(2), 183-199.

Wikipedia (2020). Chittagong Hill Tracts. Retrieved July 20, 2020, from https://en.wikipedia.org/wiki/Chittagong_Hill_Tracts

Zakaria, M., Karim, R., Rahman, M., Cheng, F., & Xu, J. (2021). Disparity in physician-patient communication by ethnicity: Evidence from Bangladesh. International Journal for Equity in Health, 20(1), 1-9.