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Effects of continuity of care and patient dispositional factors on the physician-patient relationship

Russell Noyes Jr., MD

Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA

Oladipo  A. Kukoyi, MD

Veterans Administration, Northern California Health Care System, Sacramento, CA, USA

Susan L. Longley, PhD

Department of Psychology, Rosalind Franklin School of Medicine and Science, North Chicago, IL, USA

Douglas R. Langbehn, MD, PhD

Departments of Biostatistics and Psychiatry, Carver College of Medicine, College of Public Health, University of Iowa, Iowa City, IA, USA

Scott P. Stuart, MD

Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA

BACKGROUND: We developed a questionnaire to examine the influence of physician and patient variables on the quality of the physician-patient relationship.

METHODS: More than 300 family medicine patients completed self-report measures of the physician-patient relationship and variables likely to influence it.

RESULTS: The quality of relationship was related to continuity of physician care (having a primary physician, duration of that relationship, and frequency of visits) and to patient dispositional variables (neuroticism, positive and negative affectivity) but not to demographic variables. The regression model included having a primary physician, duration of relationship with that physician, and positive affectivity. Relationship quality was, in turn, associated with outcomes (adherence to care, treatment response, satisfaction with care, and commitment to physician).

CONCLUSIONS: The quality of physician-patient relationship is influenced by physician continuity and patient dispositional variables. Better understanding of these may contribute to the therapeutic potential of this important relationship.

KEYWORDS: physician-patient relationship, satisfaction, continuity, alliance, positive affectivity


CORRESPONDENCE: Russell Noyes, Jr., MD Psychiatry Research, Medical Education Building, Iowa City, IA 52242-1000, E-MAIL:
Annals of Clinical Psychiatry ©2011 Quadrant HealthCom Inc.

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