Physician communication styles in initial consultations for hematological cancer.

Journal Article (Journal Article)

OBJECTIVE: To characterize practices in subspecialist physicians' communication styles, and their potential effects on shared decision-making, in second-opinion consultations. METHODS: Theme-oriented discourse analysis of 20 second-opinion consultations with subspecialist hematologist-oncologists. RESULTS: Physicians frequently "broadcasted" information about the disease, treatment options, relevant research, and prognostic information in extended, often-uninterrupted monologs. Their communicative styles had one of two implications: conveying options without offering specific recommendations, or recommending one without incorporating patients' goals and values into the decision. Some physicians, however, used techniques that encouraged patient participation. CONCLUSIONS: Broadcasting may be a suboptimal method of conveying complex treatment information in order to support shared decision-making. Interventions could teach techniques that encourage patient participation. PRACTICE IMPLICATIONS: Techniques such as open-ended questions, affirmations of patients' expressions, and pauses to check for patient understanding can mitigate the effects of broadcasting and could be used to promote shared decision-making in information-dense subspecialist consultations.

Full Text

Duke Authors

Cited Authors

  • Chhabra, KR; Pollak, KI; Lee, SJ; Back, AL; Goldman, RE; Tulsky, JA

Published Date

  • December 2013

Published In

Volume / Issue

  • 93 / 3

Start / End Page

  • 573 - 578

PubMed ID

  • 24035463

Pubmed Central ID

  • PMC3852201

Electronic International Standard Serial Number (EISSN)

  • 1873-5134

Digital Object Identifier (DOI)

  • 10.1016/j.pec.2013.08.023


  • eng

Conference Location

  • Ireland