A Review of the Evidence and Recommendations on Communication Skills and the Patient–Provider Relationship: A Rome Foundation Working Team Report

• Published in: Gastroenterology (New York, N.Y. 1943) Vol. 161; no. 5; pp. 1670 - 1688.e7
• Main Authors: Drossman, Douglas A., Chang, Lin, Deutsch, Jill K., Ford, Alexander C., Halpert, Albena, Kroenke, Kurt, Nurko, Samuel, Ruddy, Johannah, Snyder, Julie, Sperber, Ami
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2021
• Subjects: Attitude of Health Personnel; Brain-Gut Axis; Communication Barriers; Communication Skills; Comprehension; Consensus; Delphi Technique; Functional Gastrointestinal Disorders; Gastroenterologists - psychology; Gastroenterology - standards; Gastrointestinal Diseases - diagnosis; Gastrointestinal Diseases - physiopathology; Gastrointestinal Diseases - therapy; Health Communication; Health Knowledge, Attitudes, Practice; Health Literacy; Humans; Patient Care; Patient Satisfaction; Patient-Centered Care; Patient–Provider Relationship; Physician-Patient Relations; Telemedicine; Communication Skills; Patient Care; PPR; DGBI; Patient-Centered Care; IOM; IBS; Functional Gastrointestinal Disorders; EHR; Patient–Provider Relationship; PREM
• ISSN: 0016-5085; 1528-0012
• DOI: 10.1053/j.gastro.2021.07.037

Over several decades, changes in health care have negatively impacted meaningful communication between the patient and provider and adversely affected their relationship. Under increasing time pressure, physicians rely more on technology than face-to-face time gathering data to make clinical decisions. As a result, they find it more challenging to understand the illness context and fully address patient needs. Patients experience dissatisfaction and a diminution of their role in the care process. For patients with disorders of gut–brain interaction, stigma leads to greater care dissatisfaction, as there is no apparent structural basis to legitimize the symptoms. Recent evidence suggests that practical communication skills can improve the patient–provider relationship (PPR) and clinical outcomes, but these data are limited.
The Rome Foundation convened a multidisciplinary working team to review the scientific evidence with the following aims: a) to study the effect of communication skills on patient satisfaction and outcomes by performing an evidence-based review; b) to characterize the influence of sociocultural factors, health care system constraints, patient perspective, and telehealth on the PPR; c) to review the measurement and impact of communication skills training on these outcomes; and d) to make recommendations to improve communication skills training and the PPR.
Evidence supports the fact that interventions targeting patient–provider interactions improve population health, patient and provider experience, and costs. Communication skills training leads to improved patient satisfaction and outcomes. The following are relevant factors to consider in establishing an effective PPR: addressing health care system constraints; incorporating sociocultural factors and the role of gender, age, and chronic illness; and considering the changing role of telehealth on the PPR.
We concluded that effective communication skills can improve the PPR and health outcomes. This is an achievable goal through training and system change. More research is needed to confirm these findings.