Deck 9: Patient-Provider Relations

Question 1

How long does an average visit to the doctor last?

A) 10 to 12 minutes
B) 5 to 9 minutes
C) Under 5 minutes
D) 12 to 15 minutes
E) 15 to 18 minutes

Answer 1

12 to 15 minutes

Question 2

The "gatekeepers" in Canada's medical system refer to specialists.

Answer 2

False

Question 3

Rita is trained in traditional nursing and also has received special training in primary care. She is affiliated with a group of private practice physicians, sees her own patients, and provides routine medical care, prescribes treatment, and emphasizes health
Promotion and illness prevention. Rita is a(n)

A) physician assistant.
B) nurse practitioner.
C) clinical nurse specialist.
D) advanced practice nurse.
E) physician.

Answer 3

nurse practitioner.

Question 4

The philosophy that health is a positive state to be actively achieved, not merely the absence of disease,

A) is a traditional therapy in Western medicine.
B) acknowledges physical and psychological influences but not spiritual influences on health.
C) is not prevalent in Western medicine.
D) is holistic health.
E) None of these answers are correct.

Question 5

According to the text, one of the changes in the philosophy of health care delivery that affects patient-provider relationships is

A) Western medicine's resistance to nontraditional therapies such as meditation and biofeedback.
B) in response to increased consumerism among patients, medical students become less egalitarian in their relationships with patients during the course of medical training.
C) that a holistic view of health is not practical in Western society.
D) that a patient should not question or even discuss their care with their provider beyond what is necessary.
E) that provider-patient relationships are becoming more egalitarian.

Question 6

Most patients

A) consider medical treatment to be of high technical quality if the provider is nice.
B) do not associate quality of care with the manner it is received.
C) feel that the technical quality of medical care is somewhat more important than the manner in which it is provided.
D) are good judges of the technical quality of the medical care they receive.
E) judge the quality of care by the amount of time they spend with a care provider.

Question 7

The changing philosophy of health care delivery means that many physicians accept the use of complementary and alternative therapies.

Question 8

Provider efforts to manage the patient-provider interaction

A) encourages patients to discuss their concerns.
B) can facilitate an accurate assessment of the level of patients' technical understanding.
C) can lead to malpractice suits in certain circumstances.
D) can help to identify when the patient may be experiencing adverse reactions to certain prescribed drugs.
E) may lead to loss of important information.

Question 9

The technical quality of medical care and the manner in which it is provided are

A) unrelated.
B) critical determinants of patient satisfaction, despite being unrelated.
C) important factors in doctor shopping.
D) critical determinants of patient satisfaction.
E) both important factors in provider-patient communication.

Question 10

When providers oversimplify terms for elderly patients, the result is

A) that the elderly patient feels like a helpless child.
B) a decrease in the rate of recovery.
C) that the elderly patient is more able to understand.
D) disturbing to patients and can have a significant effect on the quality of the patient-provider relationship.
E) an increase in the rate of recovery.

Question 11

What is the duration of the Physician Assistant Education Master's degree program?

A) Two years.
B) One year.
C) Three semesters.
D) Three years.
E) There is no such program yet.

Question 12

Which of the following is a provider behaviour that interferes with provider-patient communication?

A) sexism
B) not listening
C) sexism, not listening, elderspeak, and use of jargon are all behaviours that interfere with provider-patient communication
D) use of jargon
E) elderspeak

Question 13

Why do people use CAM, given that traditional health care is paid for under Canada's universal health care system, and for the most part CAM is not?

A) The people who use CAM tend to be lower in socio-economic status, and use of CAM is subsidized for them.
B) Consultations with CAM providers tend to be shorter saving time for the patient and provider.
C) The people who use CAM tend to be higher in socio-economic status, making cost less of an issue and consultations with CAM providers tend to be longer and often take psychosocial aspects of the patient's life into account.
D) CAM treatments take longer than traditional treatments, giving people more time off work.
E) Treatment procedures are included in the CAM consultations and visits to CAM providers.

Question 14

The typical physician assistant program lasts two years.

Question 15

Good communication between patient and provider leads to a vague sense of satisfaction, but does not improve adherence to treatments.

Question 16

According to what the text says about the use of jargon, studies reveal that providers

A) overestimate the level of their patients' understanding of medical terms.
B) tend to blame themselves for their patients' lack of knowledge of medical terms.
C) accurately report that patients' knowledge of medical terms is quite low.
D) underestimate the level of their patients' understanding of medical terms.
E) tend to blame the Internet for the patient's lack of knowledge of medical terms.

Question 17

Under what category of common CAM practices do diets, herbs, and vitamins fall?

A) Alternative medical systems
B) Biologically based approaches
C) Mind-body interventions
D) Energy therapies
E) Manipulative and body-based therapies

Question 18

Elderspeak

A) has a positive impact on the health care provider and the patient.
B) simplifies communication between patient and provider.
C) has short-term health consequences for the person using elderspeak.
D) is another term for baby talk.
E) is an overly caring and infantilizing communication issue that sends the message that elderly people are incompetent.

Question 19

Telehealth

A) is not an effective way to receive advice or treatment for an illness.
B) always requires the patient to follow-up in person with their health care provider.
C) includes a variety of services that use communication technology to connect people with health services.
D) is useful for advice and consultation but not diagnosing or treatment.
E) helps to connect patients with doctors.

Question 20

Problems with the structure of health care delivery system in Canada include

A) specialized care requires a referral.
B) many Canadians do not have a family physician.
C) long wait times.
D) not enough use of complementary and alternative medicine.
E) specialized care requires a referral, not enough family physicians, and long wait times.

Question 21

When patients do not adopt the behaviours and treatments their providers recommend it is called non-adherence.

Question 22

Disclosure of complementary and alternative medicine use to physicians ranges from only 22 to 42 percent.

Question 23

Patient-centered communication is an important way to improve the patient-provider dialogue.

Question 24

Satisfaction with treatment tends to be higher when

A) the physician takes an authoritative stance.
B) the physician acts worried about the patient's health.
C) the physician is shy and reserved.
D) the physician is older than the patient.
E) a person is seen by a provider of the same race or ethnicity.

Question 25

The best predictor of physician sensitivity is

A) gender.
B) an interest in people.
C) extraversion.
D) technical competence.
E) idealism.

Question 26

Efforts to identify the personalities of physicians who communicate effectively have revealed that

A) there is no one reliable characteristic that predicts good communication skills.
B) interest in people is the only reliable indicator of physician sensitivity.
C) physicians scoring high on extraversion are effective communicators and there are multiple reliable indicators of physician sensitivity.
D) physicians scoring high on extraversion are effective communicators.
E) there are multiple reliable indicators of physician sensitivity.

Question 27

Communication skills training for physicians should include

A) the use of simple rules of courtesy.
B) simple tactics that should become second nature.
C) cognitive, behavioural, and psychological aspects.
D) the effective use of nonverbal behaviours.
E) a focus on patient-centered dialogue.

Question 28

Which of the following are often stereotyped as being quiet and passive?

A) First Nations patients.
B) patients with psychological disorders.
C) chronically ill patients.
D) sicker patients.
E) acutely ill patients.

Question 29

Unsatisfactory patient-provider interaction has been noted as a reason for using complementary and alternative medicine.

Question 30

The study by Ni´ Chróinín and colleagues (2011) found that although 72 percent of patients being discharged felt that they had a good understanding of their diagnoses,

A) younger patients were more likely to falsely report their level of comprehension.
B) older patients and those with cognitive impairments were less likely to have a clear understanding.
C) one-half did not follow-through with their doctor's recommendations.
D) more than half of the patients studied sought a second opinion to clarify the original diagnosis.
E) compared to women, men were less likely to follow-through with their doctor's recommendation.

Question 31

Patients do not disclose their use of complementary and alternative medicine CAM to their physicians because they

A) believe the use of CAM is their personal choice only and is independent of any other treatment the patient may choose.
B) feel their physician did not explicitly ask them about CAM use.
C) expect their physician to deny them treatment.
D) believe that their physician knows about their use of CAM from the CAM provider.
E) feel that CAM will interfere with the treatment that the physician will provide.

Question 32

Qualities of the medical interaction that facilitate communication are

A) about having agreeable personality traits.
B) that patients are more likely to provide negative rather than positive feedback.
C) that patients seldom provide feedback about the effectiveness of providers' communication.
D) that many patients are relatively cautious with providers.
E) that providers receive little feedback from their patients.

Question 33

Which of the following is NOT associated with patient-centered communication?

A) It is well-suited for working with patients with more advanced communication deficits such as stroke survivors.
B) It is especially effective with "difficult" patients, such as those who are high in anxiety.
C) It is an important way to improve the patient outcomes.
D) It is more dependent on the physician's gender.
E) It enlists the patient directly in decisions about medical care.

Question 34

Adherence to treatment is substantially increased when providers are able to draw on their personal authority as high-status figures, as well as their power of medical authority.

Question 35

According to a study of patient-provider communication skills conducted by Thompson, Nanni, and Schwankovsky (1990), patient satisfaction, perceptions of personal control, and patient question asking was highest in

A) women who had done research on the Internet before the visit.
B) women who had stronger personalities.
C) women whose physicians encouraged the asking of questions.
D) women who listed questions before the visit.
E) women who listed questions before the visit and women whose physicians encouraged the asking of questions.

Question 36

Of the following, which is NOT an important factor in increasing adherence to treatment?

A) Modifying institutional procedures for following patients.
B) Following up with the patient by phone or postcard.
C) Presenting the treatment regimen clearly.
D) Increasing the skill of the practitioner in communicating with the patient.
E) Adopting a business-like attitude.

Question 37

The study of 20 randomly chosen hospitals in Quebec found that patients with communication problems in the delivery of their care

A) tended to suffer from relatively minor health problems.
B) were less likely to complain to the ministry.
C) were more dissatisfied with the hospital staff.
D) were the elderly.
E) were at greater risk for experiencing multiple preventable adverse events.

Question 38

Adherence to treatment is improved when providers

A) provide verbal rather than written instructions about treatment, dosage, and side effects.
B) involve the patient's spouse or partner.
C) take empathy training.
D) ask patients about potential barriers to adherence.
E) use their personal authority to prescribe treatments rather than to simply urge patients to adhere.

Question 39

Adi chose CAM over traditional treatment for treating his arthritis. Which reason is the most appropriate that motivated him to take CAM treatment?

A) His physician is very far from his home, while the CAM provider is not that far from home.
B) The physician does not project authority and confidence.
C) His physician is over-caring which makes him feel uncomfortable.
D) The CAM provider fulfills needs not met by the conventional physician.
E) CAM is cheaper than conventional medical care.

Question 40

One factor in patients' contribution to faulty communication is because patients

A) rely too heavily on misinformation on the Internet.
B) often respond to different cues than do providers and provide faulty cues about their true concerns.
C) have little difficulty interpreting and reporting their symptoms.
D) are more concerned with their underlying illness than its symptoms than are providers.
E) present their most distressing symptoms clearly and precisely; most faulty communication occurs with minor symptoms.

Question 41

Rana is required to take two pills of a statin in a day. He breaks the pills into quarters and has two quarters instead each day. Rana's behaviour is an example of

A) creative non-adherence.
B) adherence.
C) non-adherence.
D) creativity.
E) creative adherence.

Question 42

The greatest cause of non-adherence to treatment is

A) faulty patient-provider communication.
B) the patient's unsupportive home environment.
C) distrust of the medical system.
D) the patient's uncooperative personality.
E) the decreasing use of traditional health plans.

Question 43

Which of the following medical suggestions would be MOST likely to show high rates of non-adherence?

A) "Please bring a stool sample back to our office at your earliest convenience".
B) "Please stop by the lab on your way out and have some blood drawn for a complete battery."
C) "Make sure you schedule a mammogram before your next appointment."
D) "Try to rest and take some annual leave from your job."
E) "Take three tablets per day for five days."

Question 44

Placebo effects vary according to

A) how a provider interacts with the patient.
B) gender of the patient.
C) how much a provider believes in the power of the placebo.
D) how a provider interacts with the patient, the provider's belief in the power of the placebo, and the provider's warmth, confidence, and empathy.
E) a provider's warmth, confidence, and empathy.

Question 45

The presence of a placebo effect is reflected in the importance placed by the medical community on

A) drug studies.
B) retrospective studies.
C) double-blind studies.
D) prospective studies.
E) pilot studies.

Question 46

Avoidant coping strategies on the part of patients are

A) are not related to non-adherence to treatment regimens.
B) unrelated with adherence to treatment regimens.
C) associated with poor adherence to treatment regimens.
D) associated with creative non-adherence.
E) associated with good adherence to treatment regimens.

Question 47

If both treatments are considered equally effective, in which of the following scenarios are you most likely to see a larger placebo response for Patient A over Patient B?

A) Patient A takes a green stimulant pill; Patient B takes a red stimulant capsule.
B) Patient A takes Buckley's Mixture cough syrup; Patient B takes a no name brand cough syrup.
C) Patient A receives a vitamin pill; Patient B receives a vitamin injection.
D) Patient A receives treatment from a new doctor at a clinic; Patient B receives treatment from her shaman (traditional healer).
E) In none of these scenarios would patient A experience a larger placebo response over Patient B.

Question 48

Placebo effects

A) have no effect over improvements in patients' medical conditions.
B) do not affect any areas of the brain.
C) do not activate any neurological mechanisms.
D) do not reduce patients' anxiety.
E) release endogenous opioids.

Question 49

Explain the various types of health care providers.

Question 50

Overall adherence rates are poorest

A) when the advice is perceived as medical.
B) for obtaining medical tests.
C) when patients have young children.
D) when the advice is vocational.
E) with complex self-care regimens.

Question 51

When patients do not adopt the recommended medical treatment, the result is termed

A) reactance.
B) malingering.
C) doctor shopping.
D) transference.
E) non-adherence.

Question 52

The placebo effect

A) accounted for much of the success of early medical treatments but is seldom an important aspect of modern medical care.
B) accounts for improvements in the patient's psychological state but is unrelated to actual physiological changes.
C) has been observed in both patients and providers.
D) accounts for about 15 percent of a drug's effect.
E) is powerful but of short duration.

Question 53

The placebo effect is solely caused by psychological expectations of improved health and alleviation of symptoms.

Question 54

Adherence is higher in patients who are

A) older
B) asked to change personal habits.
C) satisfied with their provider.
D) younger, white, and female.
E) anxious and vigilant.

Question 55

Creative non-adherence

A) is unrelated to disease prototypes.
B) seriously undermines a patient's health.
C) is an effective coping strategy.
D) is essentially when a patient lies to a doctor to avoid unpleasant treatments.
E) may be a patient's attempt to reassert control over their illness and its treatment.

Question 56

For the most part, patients' estimates of their rates of adherence are

A) artificially high.
B) reliable.
C) accurate.
D) creative.
E) artificially low.

Question 57

Teaching physicians can increase treatment adherence.

A) to follow up on treatments
B) to have pharmacies in their clinics
C) to lengthen the duration of their times with patients
D) the advantages of adherence
E) to communicate effectively

Question 58

For short-term antibiotic regimens, an estimated fail to comply adequately.

A) one-eighth
B) one-quarter
C) one-third
D) one-fifth
E) three-quarters

Question 59

Researchers examining the links between the Big Five Factors and placebo responding has found that

A) people scoring high in neuroticism were more likely to experience the placebo effects.
B) people scoring high in conscientiousness were more likely to experience placebo effects.
C) people scoring low in agreeableness were more likely to experience placebo effects.
D) people scoring high in extraversion were more likely to experience placebo effects.
E) people scoring low in openness were more likely to experience placebo effects.

Question 60

Which of the following is NOT one of the three steps your text lists as critical in adherence?

A) Self-efficacy.
B) Satisfaction with the relationship and treatment regimen.
C) Deciding to adhere.
D) Understanding the treatment regimen.
E) Satisfactory communication with the health care provider's office staff.

Question 61

Explain the causes of treatment adherence and treatment non-adherence. Discuss how non-adherence can be reduced.

Question 62

Discuss the factors that have contributed to patient consumerism and how patient consumerism has affected the patient-provider relationship.

Question 63

How can patient-provider communication be improved?

Question 64

Explain how health care providers might use the placebo effect to its best advantage.

Question 65

Explain the ways in which interventions that target health care providers' communication skills may be related to increased patient satisfaction and increased treatment adherence.

Question 66

A friend is laughing about another friend's self-prescribed herbal remedies. He scoffs that the placebo effect is purely psychological, thus "all in your head." Explain the nature and effect of placebos, and why this statement is inaccurate.