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Assessing Communication Between Patients and Physicians: The Measure of Patient-Centred Communication #95-2

J.B. Brown, M. Stewart, B.L. Ryan
December 2001

EXECUTIVE SUMMARY

For over two decades the Patient-Doctor Communication Group at the Centre for Studies in Family Medicine, The University of Western Ontario has concentrated on the development, research and dissemination of the Patient-Centered Clinical Method (PCCM).  Since our initial publications in 1986, the method has evolved considerably.  The clinical method currently consists of six interactive Components that integrate the conventional medical model with an approach that endeavours to understand the patient's unique illness experience.  The first Component is the exploration of two conceptualizations of ill health - disease and illness.  In addition to assessing the disease process, by history and physical examination, the physician actively seeks to enter the patient's world - to understand their unique illness experience.  The second interactive Component of the patient-centered method is the integration of these concepts of disease and illness with an understanding of the whole person.  This includes an awareness of the patient's position in the life cycle and the context in which they live (i.e. family, work, culture).  Finding common ground between the physician and the patient is the third Component of the method and consists of three key areas: the patient and physician mutually defining the problem; establishing the goals of treatment and/or management; and identifying the roles to be assumed by both.  The fourth Component emphasizes the importance of using each encounter as an opportunity for prevention and health promotion.  The fifth Component takes into consideration that each contact with the patient should be used to build on the patient-physician relationship as a basis of their continuing work together.  The sixth Component requires that, throughout the process, the physician is realistic about time, availability and accessibility of resources, and amount of emotional and physical energy needed.

This paper describes the Measure of Patient-Centered Communication (MPCC) which reflects the first three Components of the PCCM.  The document provides an overview of the PCCM as well as a manual which includes working definitions for each component to be measured; examples; coding and scoring procedures; and coding forms.