Physicians' Knowledge and Self-Reported Compliance Promotion as Predictors of Performance with Simulated Lung Disease Patients

Abstract

Scores on a test of knowledge of chronic lung disease and self-reports of actions to enhance compliance in chronic-disease patients were obtained from 42 primary-care physicians. Tvo years latereach physician was audiotaped during encounters with two simulated lung disease patients. Transcripts were used to scorephysician performance and to analyze communication. Audiotapes of the encounters were alsoplayed to role-playing subjects (N = 252) to ascertain likely patient outcomes. More knowledgeable physicians displayed more clinical expertise, gave more patient education, engaged in less social-emotional talk and induced more satisfaction and recall by role-playing subjects. Physicians who said they worked harder to achieve compliance were shown to be more likely to ask more appropriate open-ended questions, ask more questions, offer less patient education, give more directions and instructions, and make more utterances.