Research Topics
| R M EpsteinSummaryAffiliation: University of Rochester Country: USA Publications
Research Grants
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Publications
What is shared in shared decision making? Complex decisions when the evidence is unclearRonald M Epstein
Center for Communication and Disparities Research, University of Rochester Medical Center, Rochester, NY 14620, USA
Med Care Res Rev 70:94S-112S. 2013..Information technology and health systems offer untapped potential to deepen the relationships and conversations within which decisions are made...- Whole mind and shared mind in clinical decision-makingRonald Mark Epstein
Departments of Family Medicine, Psychiatry, Oncology and Nursing and the Center for Communication and Disparities Research, University of Rochester Medical Center, Rochester, NY, USA
Patient Educ Couns 90:200-6. 2013..To review the theory, research evidence and ethical implications regarding "whole mind" and "shared mind" in clinical practice in the context of chronic and serious illnesses... 
Study protocol: a randomized controlled trial of patient navigation-activation to reduce cancer health disparitiesSamantha Hendren
Department of Surgery, University of Michigan, Ann Arbor, MI, USA
BMC Cancer 10:551. 2010..The purpose of this clinical trial is to test the effectiveness of an intervention combining patient navigation and activation to improve cancer treatment...- "I didn't know what was wrong:" how people with undiagnosed depression recognize, name and explain their distressRonald M Epstein
Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
J Gen Intern Med 25:954-61. 2010..Diagnostic and treatment delay in depression are due to physician and patient factors. Patients vary in awareness of their depressive symptoms and ability to bring depression-related concerns to medical attention... 
Communicating evidence for participatory decision makingRonald M Epstein
Rochester Center to Improve Communication in Health Care, Department of Family Medicine, University of Rochester Medical Center, Rochester, NY 14620, USA
JAMA 291:2359-66. 2004....- Comprehensive assessment of professional competence: the Rochester experimentRonald M Epstein
Department of Family Medicine, University of Rochester School of Medicine and Dentistry, New York 14620, USA
Teach Learn Med 16:186-96. 2004..A required 2-week comprehensive assessment (CA) for 2nd-year medical students that integrates basic science, clinical skills, information management, and professionalism was implemented... - "Could this be something serious?" Reassurance, uncertainty, and empathy in response to patients' expressions of worryRonald M Epstein
Department of Family Medicine, Rochester, NY, USA
J Gen Intern Med 22:1731-9. 2007..Previous work suggests that exploration and validation of patients' concerns is associated with greater patient trust, lower health care costs, improved counseling, and more guideline-concordant care... - Physicians' responses to patients' medically unexplained symptomsRonald M Epstein
Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
Psychosom Med 68:269-76. 2006..To understand how physicians communicate may contribute to the mistrust and poor clinical outcomes observed in patients who present with medically unexplained symptoms (MUS)... - Patient-centered communication and diagnostic testingRonald M Epstein
Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
Ann Fam Med 3:415-21. 2005..We studied the relationship between patient-centered communication and diagnostic testing expenditures... - Measuring patient-centered communication in patient-physician consultations: theoretical and practical issuesRonald M Epstein
Department of Family Medicine, University of Rochester, 1381 South Avenue, Rochester, NY 14620, USA
Soc Sci Med 61:1516-28. 2005..The increasing influence of the PCC literature to guide medical education, licensure of clinicians, and assessments of quality provides a strong rationale for further clarification of these measurement issues... - Self-monitoring in clinical practice: a challenge for medical educatorsRonald M Epstein
Rochester Center to Improve Communication in Health Care, University of Rochester School of Medicine and Dentistry, Rochester, NY 14610, USA
J Contin Educ Health Prof 28:5-13. 2008.... - Exploring and validating patient concerns: relation to prescribing for depressionRonald M Epstein
Department of Family Medicine, University of Rochester Medical Center, Rochester, NY 14610, USA
Ann Fam Med 5:21-8. 2007..This study examined moderating effects of physician communication behaviors on relationships between patient requests for antidepressant medications and subsequent prescribing... - Assessment in medical educationRonald M Epstein
Department of Family Medicine, and the Rochester Center to Improve Communication in Health Care, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
N Engl J Med 356:387-96. 2007 - Mindful practiceR M Epstein
Department of Family Medicine, University of Rochester School of Medicine and Dentistry, New York 14620, USA
JAMA 282:833-9. 1999..As a link between relationship-centered care and evidence-based medicine, mindfulness should be considered a characteristic of good clinical practice... - Talking about AIDSR M Epstein
Department of Family Medicine, University of Rochester School of Medicine and Dentistry, Highland Hospital Primary Care Institute, New York, USA
AIDS Patient Care STDS 13:545-53. 1999..Although studies indicate that experienced practitioners often do not have these skills, they can be learned... - Improving physicians' HIV risk-assessment skills using announced and unannounced standardized patientsR M Epstein
Highland Primary Care Institute, University of Rochester School of Medicine, Rochester, NY 14620, USA
J Gen Intern Med 16:176-80. 2001..To evaluate feasibility and to validate a rating scale for two educational programs that use standardized patient-instructors (SPIs) in the office setting to improve physicians' HIV risk communication skills... - Pudor, honor, and autoridad: the evolving patient-physician relationship in SpainR M Epstein
Department of Family Medicine and Psychiatry, University of Rochester, 885 South Avenue, NY, USA
Patient Educ Couns 45:51-7. 2001..Despite agreement on the goals of medicine, the behavioral manifestations of empathy and caring in Spain contrast substantially with northern European and North American cultures... - Defining and assessing professional competenceRonald M Epstein
University of Rochester School of Medicine and Dentistry, 885 South Ave, Rochester, NY 14620, USA
JAMA 287:226-35. 2002..However, they may underemphasize some important domains of professional medical practice, including interpersonal skills, lifelong learning, professionalism, and integration of core knowledge into clinical practice... - Shared mind: communication, decision making, and autonomy in serious illnessRonald M Epstein
Departments of Family Medicine, Psychiatry, and Oncology, School of Medicine and Dentistry, and the and School of Nursing, University of Rochester Medical Center, Rochester, New York, USA
Ann Fam Med 9:454-61. 2011..By drawing attention to shared mind, clinicians can observe in what ways they can promote it through bidirectional sharing of information and engaging in shared deliberation... - How students learn from community-based preceptorsR M Epstein
Highland Hospital Primary Care Institute, Department of Family Medicine, University of Rochester School of Medicine and Dentistry, NY 14620 2399, USA
Arch Fam Med 7:149-54. 1998..To explore how students learn in community-based family physicians' offices from the student's point of view... - Factors affecting physicians' responses to patients' requests for antidepressants: focus group studyAleksey Tentler
Rochester Center to Improve Communication in Health Care, Department of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
J Gen Intern Med 23:51-7. 2008..The ways in which patients' requests for antidepressants affect physicians' prescribing behavior are poorly understood... - Changes in self-perceived abilities among male and female medical students after the first year of clinical trainingStephen J Lurie
School of Medicine and Dentistry, University of Rochester, USA
Med Teach 29:921-6. 2007..Aims: To assess whether male and female medical students change in their self-rated work habits and interpersonal habits during the first year of clinical training... - Getting patients to exercise more: a systematic review of underserved populationsJennifer K Carroll
University of Rochester School of Medicine, Family Medicine Research Programs, 1381 South Avenue, Rochester, NY 14620, USA
J Fam Pract 57:170-6, E1-3, 1 p following E3. 2008 - Clinician-patient communication about physical activity in an underserved populationJennifer K Carroll
University of Rochester School of Medicine, Family Medicine Research Programs, 1381 South Avenue, Rochester, NY 14620, USA
J Am Board Fam Med 21:118-27. 2008..Our goal was to assess primary care physicians' use of the 5A model in discussions with underserved populations about physical activity... - Relationship between peer assessment during medical school, dean's letter rankings, and ratings by internship directorsStephen J Lurie
Office of Educational Evaluation and Research, University of Rochester School of Medicine and Dentistry, Rochester, NY 14624, USA
J Gen Intern Med 22:13-6. 2007..It is not known to what extent the dean's letter (medical student performance evaluation [MSPE]) reflects peer-assessed work habits (WH) skills and/or interpersonal attributes (IA) of students... - Further challenges in measuring communication skills: accounting for actor effects in standardised patient assessmentsStephen J Lurie
Office of Educational Evaluation and Research, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
Med Educ 42:662-8. 2008..It is unclear, however, whether such evaluations may be overly biased by respondents' rating styles, which may lead to unreliable measurement of examinees' communication skills... - Have you really addressed your patient's concerns?Ronald M Epstein
Department of Family Medicine, University of Rochester School of Medicine and Dentistry, NY, USA
Fam Pract Manag 15:35-40. 2008 - Qualitative analysis of medical student impressions of a narrative exercise in the third-year psychiatry clerkshipDavid Garrison
Department of Psychiatry, University of Rochester Medical Center, Rochester, New York 14641, USA
Acad Med 86:85-9. 2011.... - Impact of peer assessment on the professional development of medical students: a qualitative studyAnne C Nofziger
Department of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642, USA
Acad Med 85:140-7. 2010..The authors investigated what types of peer feedback students remember and what reactions or transformations students experience as a result of peer assessment... - Patients' experiences with navigation for cancer careJennifer K Carroll
University of Rochester, Department of Family Medicine, United States
Patient Educ Couns 80:241-7. 2010..We examined how navigation, defined as the assessment and alleviation of barriers to adequate health care, influences patients' perspectives on the quality of their cancer care... - Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physiciansMichael S Krasner
Department of Internal Medicine, University of Rochester Medical Center, Rochester, New York, USA
JAMA 302:1284-93. 2009..Primary care physicians report high levels of distress, which is linked to burnout, attrition, and poorer quality of care. Programs to reduce burnout before it results in impairment are rare; data on these programs are scarce... - So much to do, so little time: care for the socially disadvantaged and the 15-minute visitKevin Fiscella
Department of Family Medicine, University of Rochester School of Medicine and Dentistry, 1381 South Ave, Rochester, NY 14620, USA
Arch Intern Med 168:1843-52. 2008..Consider the following scenario... - Physician personality characteristics and inquiry about mood symptoms in primary carePaul R Duberstein
Laboratory of Personality and Development, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY 14642, USA
J Gen Intern Med 23:1791-5. 2008..Depression treatment is often initially sought from primary care physicians... - Patient-centered communication during primary care visits for depressive symptoms: what is the role of physician personality?Benjamin P Chapman
Department of Psychiatry, University of Rochester Medical Center, Rochester, New York 14642, USA
Med Care 46:806-12. 2008..Aside from patient presentation, little is known about other influences on PCC. We investigated whether PCC is influenced by personality dispositions of primary care providers, independent of patient presentation... - Recall-promoting physician behaviors in primary careJordan Silberman
Rochester Center to Improve Communication in Health Care, University of Rochester Medical Center, Rochester, NY 14610, USA
J Gen Intern Med 23:1487-90. 2008..Studies suggest that patients forget a great deal of important information and that recall can be increased through recall-promoting behaviors (RPBs) like repetition or summarization... - Influences on patients' ratings of physicians: Physicians demographics and personalityPaul Duberstein
Department of Psychiatry, University of Rochester Medical Center, Rochester, NY 14642, USA
Patient Educ Couns 65:270-4. 2007..There is considerable interest in the influences on patients' ratings of physicians... - Emotion language in primary care encounters: reliability and validity of an emotion word count coding systemCleveland G Shields
Department of Family Medicine, University of Rochester Medical Center, Rochester Center to Improve Communication in Health Care, 1381 South Avenue, Rochester, NY 14620 2830, USA
Patient Educ Couns 57:232-8. 2005..To develop a reliable and valid computer coded measure to assess emotional expression from transcripts of physician-patient interactions... - Patient trust: is it related to patient-centered behavior of primary care physicians?Kevin Fiscella
Department of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
Med Care 42:1049-55. 2004..Despite the potential importance of trust, there are few studies of its correlates using objective measures of physician behavior during encounters with patients... - Effects of rater selection on peer assessment among medical studentsStephen J Lurie
Curricular Affairs Office, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
Med Educ 40:1088-97. 2006..It is also unclear whether low-rated students are more likely to ask to rate one another... - Physician self-disclosure in primary care visits: enough about you, what about me?Susan H McDaniel
Department of Family Medicine, University of Rochester School of Medicine and Dentistry, and Department of Medicine, Rochester General Hospital, NY 14620, USA
Arch Intern Med 167:1321-6. 2007..The value of physician self-disclosure (MD-SD) in creating successful patient-physician partnerships has not been demonstrated... - Influence of accompanied encounters on patient-centeredness with older patientsCleveland G Shields
University of Rochester Medical Center, Department of Family Medicine, Rochester Center to Improve Communication in Health Care, Rochester, NY 14620 2830, USA
J Am Board Fam Pract 18:344-54. 2005..To conduct a pilot study to examine physician patient interaction when elderly patients are accompanied during a medical visit... - Temporal and group-related trends in peer assessment amongst medical studentsStephen J Lurie
School of Medicine and Dentistry, University of Rochester, Rochester, New York 14642, USA
Med Educ 40:840-7. 2006..Abilities appear to be stable between Years 2 and 3 of medical school. Groups may differ in their ability to discriminate different kinds of skills. Generalisability analysis can be used to discover these patterns within groups... - Rochester Participatory Decision-Making Scale (RPAD): reliability and validityCleveland G Shields
Department of Family Medicine, University of Rochester Medical Center, Rochester Center to Improve Communication in Health Care, Rochester, NY, USA
Ann Fam Med 3:436-42. 2005..We wanted develop a reliable and valid objective measure of patient-physician collaborative decision making, the Rochester Participatory Decision-Making Scale (RPAD)... - Making communication research matter: what do patients notice, what do patients want, and what do patients need?Ronald M Epstein
Department of Family Medicine, University of Rochester School of Medicine and Dentistry, 1381 South Avenue, Rochester, NY 14610, USA
Patient Educ Couns 60:272-8. 2006..To explore limitations of current communication theory by considering different perspectives of researchers, clinicians, patients and teachers of communication... - Patient navigation from the paired perspectives of cancer patients and navigators: a qualitative analysisAmanat M Yosha
University of Rochester, Department of Family Medicine, Rochester, NY 14620, USA
Patient Educ Couns 82:396-401. 2011..We explored the strengths, limitations, and our own lessons learned about adopting the novel methodology of multiperspective analysis... - Somatization reconsidered: incorporating the patient's experience of illnessR M Epstein
Primary Care Institute, Highland Hospital, Department of Family Medicine, University of Rochester School of Medicine and Dentistry, NY 14620, USA
Arch Intern Med 159:215-22. 1999..Health systems can help coordinate care and avoid iatrogenic harm by appropriately controlling access to medical services... - Is communication a skill? Communication behaviors and being in relationKathy Zoppi
Department of Family Medicine, Indiana University, Indianapolis 46202 5102, USA
Fam Med 34:319-24. 2002..Reconciling these two views supports the thesis that good communication is both a skill and a way of being, that it is both innate and teachable, and that it must be cultivated by integrated methods of teaching and research... - The biopsychosocial model 25 years later: principles, practice, and scientific inquiryFrancesc Borrell-Carrio
Department of Medicine, University of Barcelona, CAP Cornellà, Catalonian Institute of Health ICS, C Bellaterra 39, 08940 Cornellà de Llobregat, Spain
Ann Fam Med 2:576-82. 2004.... - Virtual physicians, health systems, and the healing relationshipRonald M Epstein
J Gen Intern Med 18:404-6. 2003 - Research guidelines for assessing the impact of healing relationships in clinical medicineWilliam L Miller
Healing Relationships in Clinical Medicine Writing Group, Lehigh Valley Hospital and Health Network, Allentown, PA, USA
Altern Ther Health Med 9:A80-95. 2003..The 2 strands are bonded by the questions addressed and by the participants in the study... - Assessing communication competence: a review of current toolsJulie M Schirmer
Family Practice Center, Maine Medical Center, 272 Congress Street, Portland, ME 04101, USA
Fam Med 37:184-92. 2005..Multiple tools are available to assess communication competence, but there are few studies that compare the tools... - Influence of patients' requests for direct-to-consumer advertised antidepressants: a randomized controlled trialRichard L Kravitz
Center for Health Services Research in Primary Care, University of California, Davis, Sacramento, CA 95817, USA
JAMA 293:1995-2002. 2005..Critics charge that it leads to overprescribing, while proponents counter that it helps avert underuse of effective treatments, especially for conditions that are poorly recognized or stigmatized... - Preventing errors in clinical practice: a call for self-awarenessFrancesc Borrell-Carrio
Department of Medicine, University of Barcelona, CAP Cornellà, Catalonian Institute of Health ICS, Cornellà de Llobregat, Spain
Ann Fam Med 2:310-6. 2004..Emotional self-awareness and self-regulation of attention can be consciously cultivated as habits to help physicians function better in clinical situations... - Physicians' shared decision-making behaviors in depression careHenry N Young
Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin Madison, Madison, USA
Arch Intern Med 168:1404-8. 2008..This study assesses the extent to which physicians enact SDM behaviors and describes factors associated with physicians' SDM behaviors within the context of depression care... - Connoisseurs of care? Unannounced standardized patients' ratings of physiciansMalathi Srinivasan
University of California Davis School of Medicine, Davis, California, USA
Med Care 44:1092-8. 2006..Using unannounced standardized patients (SPs) may overcome some of these limitations because their experience and training make them able judges of physician behavior... - Types of information physicians provide when prescribing antidepressantsHenry N Young
Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin, Madison, WI, USA
J Gen Intern Med 21:1172-7. 2006..Providing antidepressant information to patients may foster greater adherence to therapy... - What drives referral from primary care physicians to mental health specialists? A randomized trial using actors portraying depressive symptomsRichard L Kravitz
Center for Health Services Research in Primary Care and Department of Internal Medicine, University of California Davis, Sacramento, CA 95817, USA
J Gen Intern Med 21:584-9. 2006..Referral from primary care to the mental health specialty sector is important but poorly understood... - In response to "medical students' views on peer assessment of professionalism"Anne C Nofziger
J Gen Intern Med 21:398-9; author reply 399. 2006 - Curriculum and clinical training in oral health for physicians and dentists: report of panel 2 of the Macy studyAllan Formicola
University of Washington School of Dentistry, USA
J Dent Educ 72:73-85. 2008 - Studying physician effects on patient outcomes: physician interactional style and performance on quality of care indicatorsPeter Franks
Department of Family and Community Medicine, Universtiy of California Davis, UC Davis Medical Center, Sacramento, 95817, USA
Soc Sci Med 62:422-32. 2006..Multi-level modeling may contribute to better understanding of the relationships between physician style and patient outcomes... - Peer assessment of professional competenceElaine F Dannefer
Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio 44195, USA
Med Educ 39:713-22. 2005..This study describes the development, implementation and results of peer assessment as a measure of professional competence of medical students to be used for formative purposes... - Do patient requests for antidepressants enhance or hinder physicians' evaluation of depression? A randomized controlled trialMitchell D Feldman
Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, USA
Med Care 44:1107-13. 2006.... - Hearing voices: patient-centered care with diverse populationsRonald M Epstein
Patient Educ Couns 48:1-3. 2002 - [Professionality and professionalism: basis, contents, praxis and teaching]Francesc Borrell-Carrio
, Universitat de Barcelona, , CAP Cornell, , , Barcelona,
Med Clin (Barc) 127:337-42. 2006 - The costs of making practice more cost-effectiveRonald M Epstein
JAMA 287:1648-9; author reply 1649-50. 2002 - Are patients' ratings of their physicians related to health outcomes?Peter Franks
Department of Family and Community Medicine, University of California, Davis, Sacramento 95817, USA
Ann Fam Med 3:229-34. 2005..Observational studies using patient reports suggest associations between physician interpersonal styles and patient outcomes. Possible confounding of these associations has not been carefully examined...
Research Grants
- PATIENT-CENTERED CARE AND HEALTH CARE COSTSRonald Epstein; Fiscal Year: 2002..abstract_text> ..