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July 5, 1995

Malpractice, Patient Satisfaction, and Physician-Patient Communication

Author Affiliations

Seattle, Wash

JAMA. 1995;274(1):22-23. doi:10.1001/jama.1995.03530010036018

To the Editor.  —I applaud the recent article by Dr Hickson and colleagues,1 which draws attention to an important topic in primary care: physician-patient communication. Their data demonstrate that for 21 obstetricians in Florida who were sued frequently, patients offered more than twice as many complaints in response to open-ended questions as did patients of 133 obstetricians who were not sued at all. Frequently, the object of these complaints was the impersonal, rushed, and unsatisfactory interpersonal interaction between patient and physician. The article and Dr Levinson's accompanying Editorial2 imply that the cause of poor communication is physicians' deficient interpersonal skills.Although I agree with the authors that interpersonal skills were targets of patient complaints, I do not agree that blaming deficient interpersonal skills is sufficient interpretation of the root cause for patient dissatisfaction. Instead, I suggest that three possible factors in addition to, or perhaps in place of,

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