Identification of Patient-Perceived Barriers to Communication between Patients and Physicians

Purpose: Barriers to full disclosure and communication of complete and accurate health history from patients to their physicians can compromise patient care. Identification of barriers to communication between patients and their physicians, and assessing communication techniques to overcome putative barriers may improve medical training, quality patient care, and patient experience. Methods: The authors performed a cross-sectional study using a novel questionnaire at an urban, inner-city hospital in Toronto, Ontario between January 1, 2011 and January 1, 2012, in order to evaluate potential barriers to communication. Variables included physician age, gender, education, ethnicity, position, perceived sexual orientation, marital status, physical attractiveness and reason for appointment. All patients attending a gynaecology appointment received the paper-based, anonymous questionnaire. Analyses applied the statistical package, SAS Software, Version 9.2. Results: Responses for 286 completed questionnaires were analysed. The most common barriers to communication included having a male physician (40.9%) and having a history taken by a medical student (24.5%). Sensitivity to having a male provider was more frequently reported in women under the age of thirty (63.6%) and nulliparous women (49.6%), p<0.05. Communication was perceived to be improved when physicians acknowledged patient concerns (95.1%), sought to understand patient concerns (91.9%), and included the patient in decisionmaking (74.1%). Conclusions: Physician gender and education level are barriers to full disclosure and communication from patients. Physicians should strive to understand patient concerns and include patients in decision-making in order to encourage full disclosure. Awareness of these obstacles is vital to promoting patient-centered care and to effective physician training.