UC Riverside

Effective clinicians need to motivate their patients to initiate and maintain beneficial health behaviors. Using transformational leadership theory as the theoretical framework, we proposed that clinicians' motivational behaviors can be organized into three "doctorship styles," or patterned approaches to patient care: passive-avoidant, transactional, and transformational. We also suggested that the styles differentially predict patient health outcomes. In Study 1, we used patient-reported questionnaires (n = 164) to examine the structure of doctorship styles and their relationship with patient outcomes. We found the second-order three-factor model to be the best model. Moreover, transformational doctorship was the only style that predicted patient adherence and it also positively predicted patient satisfaction above and beyond transactional doctorship. In Study 2, we used ratings of audio recordings of doctor-patient interactions and patient-reported post-visit questionnaires (n = 297) to examine the correlates of doctorship styles. We found that transformational doctorship positively predicted patient satisfaction and adherence, whereas transactional and passive-avoidant doctorship were not related to these variables. Finally, we found that passive-avoidant doctorship negatively predicted patients' outlook for their future health status, whereas transformational doctorship style positively predicted patients' outlook. Together these findings provide support for the doctorship styles framework and suggest a novel and fruitful direction for the study of clinicians' motivational behaviors.