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Robin DiMatteo

Distinguished Professor of Psychology
Robin DiMatteo
Doctor-Patient Communications
Professor DiMatteo’s research has shown that after more than a quarter of patient visits with their doctors, patients fail to act upon the prescribed course of action. In some chronic disease conditions, that number rises to 60 percent of patient visits. UCR research has identified effective strategies for improving health-related communications and patient adherence.

Areas of Expertise

Select Honors and Distinctions

  • Investigator Award in Health Policy Research, Robert Wood Johnson Foundation
  • Distinguished Teaching Award
  • Fellow, American Association for the Advancement of Science

Research Summary

Role of doctor-patient communication in patient adherence to recommended treatments; effective communication strategies to improve adherence and health outcomes; nonverbal communication.

Q&A

Q: Why is your work important?
When patients are not adherent and communication is not optimal, many opportunities for effective disease management are missed. Patients do not benefit from medical treatments that could offer them higher quality of life. And when patients’ health suffers due to nonadherence, their physicians can become concerned and frustrated, and feel less satisfied with their own jobs. In economic terms, nonadherence costs the US health care system as much as 300 billion dollars a year—in wasted medical visits, complications, and disease progression that could have been avoided.

Q: Why are patients nonadherent to their doctors’ recommendations?
There are many reasons for nonadherence. My students and I have been studying the copious research on this subject and how to apply it to patient care. Patients are most at risk for nonadherence when they (1) do not understand their disease and treatments, (2) do not believe in the value of adhering, and (3) lack the social resources and other supports necessary to overcome the barriers to adherence. Effective communication with patients is essential; it involves building trust, openly exchanging information relevant to care, patient activation and involvement, physician respect for and understanding of patient’s cultural and social norms, and the assessment of patients’ economic stresses, emotional challenges, family supports, and hopes for the future. Our research shows that physicians and other health professionals can learn effective strategies for communicating and managing adherence effectively.

Q: How did you get interested in this area?
For as long as I can remember, I wanted to be a teacher. As a mathematics major at Tufts, I became very interested in statistics and in psychological research, so I earned a double-major in Math and Psychology. As a Ph.D. student at Harvard, I was incredibly fortunate that my mentor was Dr. Robert Rosenthal, who is now a member of the UCR Psychology department. Our research team worked on the study of nonverbal communication, and it became clear to me that very subtle aspects of communication, such as fleeting facial expressions, gestures, and tone of voice, can have enormous effects on the receiver of a verbal message. So as a graduate student, I decided to study how physicians’ nonverbal communication in the primary care medical setting could affect important outcomes like satisfaction, adherence, and patient health.

Q: What are the big challenges researchers in your field are trying to answer?
Perhaps one of the greatest challenges in health care delivery today involves what researchers call the “health-wealth gradient.” The social and economic circumstances of people’s lives have very strong effects on their health. Social class and ethnic disparities affect not only housing, wealth, jobs, education, and access to health care but also opportunities to stay healthy (such as through diet, exercise) and effective communication in the medical setting. People are bombarded by health information every day, in the mass media, online, and in social networks, and they are advised to “talk to your doctor.” That may sound simple for some, but doctor-patient communication can be highly variable and challenging, particularly when doctors and patients come from different socio-economic backgrounds.

Q: How will your research help train a new generation of doctors?
For decades, research has shown that most medical students begin their training with quite good communication skills and a dedication to viewing each patient as a whole person. Over the course of training, communication skills diminish and their attitudes tend to become more negative. My hope is to find ways to help physicians maintain their communication skills and their humanity throughout training, and to offer them the opportunity to use behavioral research to better care for their patients.

Q: What does “Living the Promise” mean to you?
I came to UCR in 1976, when our campus had only about 4,500 students. I was strongly interested in health issues, but without a medical school, it was difficult to find research sites and colleagues with whom to work. Fortunately, although health psychology was a new area for our Psychology department, my colleagues encouraged me to use creative interdisciplinary approaches to pursue my interests. As UCR embarks on our medical school, I feel that the promise and excitement of our campus is taken into the realm of research about which I am most passionate—the delivery of quality health care that is firmly built on an evidence base, and that provides for even the most socio-economically vulnerable in a way that protects resources to make care affordable to all.

Q: Who is the most influential public voice in your field and what are they saying?
Jim Yong Kim, M.D., Ph.D., who is the President of Dartmouth, has a wonderful quote which I have under my email signature because I think it is so important: “The rocket science in health and health care is how we deliver it.” The most influential voices, including Dr. Kim’s, are asking how we can find scientific solutions for providing high-quality health care at lower cost to all members of our society. I am excited to be a small part of this awesome endeavor.

Q: In your spare time, what are you reading?
I am particularly drawn to stories of personal psychological resilience, whether in the form of memoirs or novels. I appreciate honest and insightful writing about the effects of childhood socio-economic vulnerability in the context of families that struggle psychologically. My favorite writers in this genre are two professors in UCR’s Department of Creative Writing—Goldberry Long and Susan Straight. I am also a fan of novelist Dani Shapiro, who also writes on these topics and whose blog I read regularly.
Robin DiMatteo “When patients do not take their medications as prescribed, fail to manage lifestyle recommendations, or use medical devices incorrectly, their health outcomes can suffer greatly.”

—Robin DiMatteo
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