Communication in Medical Encounters: An Ecological Perspective

Has managed care made it harder for patients and physicians to talk openly and honestly with one another? Has the Internet changed the way patients communicate with their doctors? What effect are new state and federal health policies (e.g., patient bills of rights) having on the health care provider-patient relationship? To what extent do race and ethnicity affect decisions made during medical consultations? These are but a few of the questions currently being asked by a variety of stakeholders of the health care system, including policymakers, managed care corporations, health care providers, patients, and media pundits, to name a few. Those of us who study health communication should be both encouraged and troubled by these questions.