Table 1

Descriptive information on observations and examples of instrumental and socioemotional communication
Setting (Physician) # Patients and visit duration Examples of instrumental communication Examples of socioemotional communication
Urban (Mary) 19 patient visits observed ● Patient asks about test results ● Greet each other by their first name
270 minutes of observation Average of 11 minutes per visit ● Patient asks for refills ● Patient asks about physician’s daughter and what grade she’s in now
(range 5 to 20 minutes) ● Patient asks when test results will be back ● Patient teases physician about being tanned from recent vacation
● Physician asks about symptoms ● Physician asks about how patient’s sibling is coping
● Physician explains tests being scheduled for patient ● Patient and physician talk about people they both know who are retiring
● Physician explains prescriptions and side effects ● Physician teases patient about smoking
● Physician reviews test results
Urban (John) 18 patient visits observed ● Patient describes symptom ● Greet each other by first name
220 minutes of observations Average of 11 minutes per visit ● Patient asks about health coverage of tests, medications ● Patient jokes that he is there because his wife told him to come in
(range 4 to 19 minutes) ● Patient asks for refills ● Physician teases patient about being an “empty nester”
● Patient asks about their self diagnosis (e.g., thyroid problem, appendix, cancer) ● Physician asks about patients’ parent’s recent surgery, about son in overseas, say “hi” to dad
● Physician explains medications and side effects ● Physician ask how patient’s recent trip was traveling with babies
● Physician asks patient if s/he has any questions about treatment or prescriptions
● Physician explains tests being scheduled for patient
● Physician reviews test results
Rural (Alan) 23 patient visits observed ● Patient describes symptoms and health concerns ● Greet each other by first name
275 minutes of observations Average of 12 minutes per visit ● Patient asks about health coverage of treatment ● They joke about aging, failing knees, bunnies do well eating salads, giving up coffee, golf not being exercise
(range 3 to 19 minutes) ● Patient asks about prescriptions and side effects ● Talk about summer vacations, exercise routine, daughter getting married, grandson in hockey tournament, restoring cars, hockey game last night, family conflicts and estrangements
● Physician reviews test results ● Physician teases patient about drinking too much at local weekend party
● Physician explains tests being scheduled for patient ● Doctor refers to some patients as “My Dear”
● Physician explains health concerns ● Physician asks patient how he’s doing and pats patient’s knee
● Physician asks about symptoms ● Physician talks to teens about sex, tattoos, drinking and drugs
Rural (Colleen) 13 patient visits observed ● Patient asks about tests and referrals ● Greet each other by first name
297 minutes of observations Average of 13 minutes per visit ● Patient describes tests and referrals ● They joke about patient falling off examining table and a good looking doctor to come help her up, about weight loss, quitting smoking,
(range 4 to 30 minutes) ● Physician asks about symptoms ● Talk about deer eating flowers, each others’ daughters, retirement celebration for a physician in the clinic, parent who is recently widowed, vacation, sister’s health, new haircut
● Physician explains test results
● Physician explains procedures
● Physician explains health concerns

Desjarlais-deKlerk and Wallace

Desjarlais-deKlerk and Wallace BMC Health Services Research 2013 13:261   doi:10.1186/1472-6963-13-261

Open Data