Medical communication, physicians' adjustment, and therapeutic relationships: exploring potential mechanisms.

Background: Research on the associations between medical communication competence (MCC) and physicians' psychological adjustment and therapeutic relationships is warranted. This study aimed to analyze the associations between MCC and both physicians' psychological adjustment outcomes (i.e. burnout and flourishing) and therapeutic relationships via barriers to compassion and expressive suppression.

Methods: A sample of 221 physicians completed an online survey, which assessed MCC, barriers to compassion, expressive suppression, burnout, flourishing and therapeutic relationships. Structural equation modeling was used to explore direct and indirect associations between variables. Multigroup analyses were performed to ascertain the invariance of the obtained model between groups of physicians with more (≥14) or fewer (<14) years of professional experience.

Results: Barriers to compassion and expressive suppression were indirectly associated with the relationship between MCC and both physician burnout (β = -.01, 95% CI [-.03, -.00] and β = -.01, 95% CI [-.02, -.00], respectively) and flourishing (β = .04, 95% CI [.01, .10] and β = .07, 95% CI [.03, .13], respectively). The association between MCC and therapeutic relationship was exclusively explained by barriers to compassion (β = .03, 95% CI [.01, .06]). The mediation model was invariant across groups of physicians with more or fewer years of professional experience.

Conclusions: Regardless of professional experience, MCC training should address physicians' barriers to compassion and emotion regulation skills to improve their psychological adjustment and the quality of their therapeutic relationships. Interventions at the physician level may impact the quality of health care at an organizational level.