Changes in physician-patient communication from initial to return visits: a prospective study in a haematology outpatient clinic.

Limited research has investigated how physician-patient interaction changes over time. We have therefore examined physician-patient communication during the two initial, as well as the seventh (on average) patient visit to a haematology outpatient clinic. Consultations were audio taped and analyzed using the Roter interaction analysis system (RIAS). Patients completed the Impact of Events Scale (IES) before and a satisfaction questionnaire after each consultation. Consultations were generally physician dominated and task-focused. While the amount of task-focused communication was significantly reduced between the initial and the return visits, the amount of socio-emotional communication remained quite stable. In return visits (but not in the two initial visits), patients with more severe diagnoses were given longer consultations and they provided more task-focused information to a less verbally dominant physician. Patients were more satisfied in the second and return visits (but not in the first), if consultations contained greater levels of socio-emotional communication.