The physician's patient schema: The foundation of physician-patient communication
Hart, Marsha Lynn Clowers
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This study seeks to determine which variables are responsible for forming physicians' schema of patients. Indications from the literature as well as thematic analysis of the transcript of a focus group of physicians guided the researcher in the formation of a 40-item Likert-type questionnaire. One hundred twenty physicians returned the questionnaire. Subsequent data analyses measures indicated no differences between male and female physicians' schema of patient communication. Thematic groupings of variables indicated in the focus group resulted in the following categories: the category "medical school" reflects the theme that physician abuse in medical school affects communication with patients, "role models" reflects the theme that physicians learn communication skills from watching other physicians, "patient concealment" reflects the theme that patient concealment and deception is an important issue to physicians, "ideal patient" is reflective of the theme that patients are good people, "difficult communication" is reflective of the theme that patients are not difficult to communicate with, and "negative attitudes" reflects the theme that physicians do not expect communication problems from patients. Data analyses indicated positive correlations between physician age and experience with the ideal patient category, and the patient concealment category. Weak negative correlations were found between the categories of ideal patient and patient concealment, medical school and negative attitudes, role models and patient concealment, and medical school and patient concealment. The findings indicate a need for increased communication skills training for physicians.