Making communication research matter: what do patients notice, what do patients want, and what do patients need?

OBJECTIVE To explore limitations of current communication theory by considering different perspectives of researchers, clinicians, patients and teachers of communication. METHOD Theory development based on limitations of the current communication research literature due to inconsistencies between patient reports and observed communication behavior. RESULTS While researchers focus on the mechanics and techniques of communication, patients seek relationships in which they experience trust, the right amount of autonomy, caring, and expertise. Patients', physicians', and communication experts' perspectives do not always define the same problems and often point to different solutions. CONCLUSIONS In addition to studying clinician behaviors and patient perceptions of care, communication research should focus on five additional factors: what patients notice, want and need, and how their perspectives differ from those of physicians and researchers; the context, including illness severity and type and family influences; how complex health systems facilitate and impede communication; patients' influences on physician communication behavior; and habits of mind that promote attentive care.