Intuitive tailoring in medical consultations: how perceived patient characteristics influence physicians’ communication

Abstract

High-quality communication during perioperative care contributes to surgical patients’ health outcomes. It is assumed that physicians can enhance the communication’s quality in a process known as tailoring by using objectively-assessed information about individual patients to determine the appropriate content, context and channel of communication. Physicians may already intuitively tailor when they adjust communication on the basis of their perception of a patient; however, understanding about this topic is limited. The aim of the current study was to examine if and how physicians’ perception a patient influences physicians’ communication. The transcripts of 80 short semi-structured interviews with orthopaedic physicians (N = 7) were submitted to qualitative content analysis. Correspondence analysis was used to explore the association between perceived patient characteristics and communication. Physicians perceived patients’ illness management and communication abilities, autonomy, and preferences for interpersonal behaviour. This resulted in changes in communication in two-thirds of the consultations. Specific associations between perceived patient characteristics and changes in communication include: (1) higher patient competence−extensive information provision or no changes, (2) less autonomy and less competence in communication−reassurance and direction, (3) high autonomy−inhibitory discussions about pace and expectations, and (4) sociability−communication about personal circumstances. A physician’s perception of a patient influences how information, guidance and personal circumstances are communicated during medical consultations. However, not all physicians tailor communication and limited evidence exists for the appropriateness of the tailoring approaches employed. The intuitively applied approaches identified in this study can be used to formulate and test empirical tailored communication strategies.