Aligning Care to Cognitive Style: A 4-Question Framework for Patient-Centered Dermatology Visits.

Abstract

Objective: To improve patient-centered dermatology care by identifying how patients prefer to approach medical decision-making and structuring their visit, using a brief 4-question intake survey focused on cognitive style.

Methods: New patients at 2 dermatology clinics within the California Skin Institute completed a multiple-choice intake questionnaire before their first visit. The survey asked patients how many concerns they wanted to address, how much guidance they preferred in selecting treatment, whether they prioritized diagnosis or treatment during the visit, and their expected timeline for results. Associations between patient responses and demographics (sex, age, chief complaint) were analyzed using χ² tests.

Results: Among 257 patients (mean age: 38; 43% female), 96% of patients preferred to address only 1 or 2 concerns during their first visit; 75% preferred shared decision-making and 70% prioritized discussing treatment over their medical history. Patients bringing multiple concerns were significantly more likely to prefer autonomous decision-making (χ²=24.0; P<0.001). Women more often preferred to discuss multiple concerns and to balance history with treatment (both P<0.01), while men leaned toward single-concern, treatment-focused visits.

Limitations: Single-center design and moderate sample size may limit generalizability.

Conclusion: This brief, previsit framework offers a structured method to align dermatologic care with patients' cognitive and decision-making preferences-enhancing efficiency, rapport, and mutual understanding prior to the clinical encounter. By facilitating clearer communication from the outset, it may improve the quality of patient-centered care. Future studies will explore whether tailoring consultation styles to patient preferences can impact adherence, satisfaction, and clinical outcomes.