" Practicing medicine": Patient perceptions of physician communication and the process of prescription

Objective: This study explores patient perceptions of physician communication regarding prescription medications and develops a theory of the effects of perceived physician communication on the patient decision-making process of medication taking. Methods: Using a grounded theory approach, this study systematically analyzed patient narratives of communication with physicians regarding prescription medications and the patient's resulting medication taking and adherence behavior. Results: Participants described concern about side effects, lack of perceived need for medications, and healthcare system factors as barriers to medication adherence. Overall, participants seemed to assess the utility of communication about these issues based on their perceptions of their physician as the source of the message. Conclusion: The theory generated here includes patient assessments of their physician's credibility (trustworthiness and expertise) as a critical influence in how chronically-ill patients process information about the need for prescribed therapy. Trial and error to find appropriate medications seemed to deteriorate patients' perceptions of their physicians' credibility. Practice implications: A practical application of this theory is the recommendation for physicians to increase perceived expertise by clearly outlining treatment processes at the outset of treatment, presenting efficacy and timeline expectations for finding appropriate medications.