AIM: To characterize the factors associated with the 'doctor' effect in primary care, as reported in randomized controlled trials (RCTs). METHOD: A systematic search of Medline (1964-2004) sought to identify all original reports of RCTs, as well as those reported in reviews and metaanalyses. We used the following key words: RCT, doctor-patient relationship, doctor-patient communication, knowledge, skill, attitude, non-pharmacologic effectiveness, primary care. RESULTS: Ten RCTs and one metaanalysis provided evidence that a combination of emotional and cognitive care has a consistently positive effect on health outcomes. This effect relies on specific attitudes and skills: empathy, reassurance, explanation, counseling, influencing patients' 'health beliefs and expectations, promoting change in behavior, thoughts or emotions. These can be integrated into a specific patient-centered approach to general practice. Medical education must provide training in the relational skills needed for effective treatment. CONCLUSION: Qualitative and quantitative research, including RCTs, are necessary; they should be designed to deal with the heterogenous situations and specific characteristics of general practice.
AIM: To characterize the factors associated with the 'doctor' effect in primary care, as reported in randomized controlled trials (RCTs). METHOD: A systematic search of Medline (1964-2004) sought to identify all original reports of RCTs, as well as those reported in reviews and metaanalyses. We used the following key words: RCT, doctor-patient relationship, doctor-patient communication, knowledge, skill, attitude, non-pharmacologic effectiveness, primary care. RESULTS: Ten RCTs and one metaanalysis provided evidence that a combination of emotional and cognitive care has a consistently positive effect on health outcomes. This effect relies on specific attitudes and skills: empathy, reassurance, explanation, counseling, influencing patients' 'health beliefs and expectations, promoting change in behavior, thoughts or emotions. These can be integrated into a specific patient-centered approach to general practice. Medical education must provide training in the relational skills needed for effective treatment. CONCLUSION: Qualitative and quantitative research, including RCTs, are necessary; they should be designed to deal with the heterogenous situations and specific characteristics of general practice.
Authors: Benjamin W Van Voorhees; Karen Vanderplough-Booth; Joshua Fogel; Tracy Gladstone; Carl Bell; Scott Stuart; Jackie Gollan; Nathan Bradford; Rocco Domanico; Blake Fagan; Ruth Ross; Jon Larson; Natalie Watson; Dave Paunesku; Stephanie Melkonian; Sachiko Kuwabara; Tim Holper; Nicholas Shank; Donald Saner; Amy Butler; Amy Chandler; Tina Louie; Cynthia Weinstein; Shannon Collins; Melinda Baldwin; Abigail Wassel; Mark A Reinecke Journal: J Can Acad Child Adolesc Psychiatry Date: 2008-11