Abstract
Background: Considerable differences exist between the ways in which communication is conceptualized in the academic field of communication studies, on the one hand, and in clinical practice, on the other. Theorists in the field of communication studies have conceptualized communication as (1) mutual and interactive, (2) concerning the establishment of shared meaning, and (3) multilevel and embedded in organizational and institutional systems. Healthcare practitioners have tended to operationalize communication as (1) directional, (2) concerning the transmission of information, and (3) dyadic in terms of physician-patient consultation.
Methods: A literature-based theoretical review focusing on the academic field of communication studies.
Results: Loosely-coupled organizational systems can excel at locale-specific innovation while failing at horizontal coordination and organizational learning. Bureaucratic tendencies of complex organizations are inherently dehumanizing. In integrated healthcare delivery systems, attaining and maintaining a state of patient-centeredness will require continual vigilance.
Conclusions: Patient-centered communication extends beyond the context of physician-patient interaction to include provider-to-provider communication, healthcare team coordination, applications of electronic medical records, intraorganizational issues of continuity of care, and interorganizational issues of patient-centered communication policy dissemination. A research agenda about patient-centered communication for integrated delivery system researchers is proposed as a means for systematically improving patient-centered communication.
- Received September 11, 2008.
