Annals of Family Medicine: Physician Warmth and Competence Shape How Patients Interpret Normal Test Results

PROVIDENCE, R.I., Sept. 15, 2026 /PRNewswire/ -- How a physician communicates normal tests results may determine how the information lands with a patient, according to a study published in Annals of Family Medicine. The study was led by Tobias Kube, PhD, of Goethe University Frankfurt and RPTU University Kaiserslautern-Landau, with Anna Seewald, PhD, of the University of Marburg.

Reassurance is incredibly important in medicine, but communicating normal test results isn't always enough to ease a patient's worries or deter them from seeking a second opinion.

In an online experiment, researchers asked 349 participants to imagine themselves having gastrointestinal symptoms and to imagine that a family member with similar symptoms had been recently diagnosed with bowel cancer. Participants were randomly assigned to one of four videos of a physician reporting their test results. The physician provided the same information in all videos: that the test results were normal, bowel cancer was very unlikely, a colonoscopy was possible but not recommended for now, and the patient should wait a few weeks and follow dietary advice. What varied was the physician's warmth and competence in her communication style. The high-warmth physician sat openly, made eye contact, smiled and used collaborative language such as "I suggest we wait to see how your symptoms develop," while the low-warmth physician folded her arms, avoided eye contact and did not smile. The high-competence physician sat upright and explained the results precisely and without filler words, while the low-competence physician searched through the patient's file, used frequent filler words and played with her pen.

Although all participants received the same diagnostic information, their responses to it differed significantly based on the physician's behavior, with competence generally producing the larger effects. Participants who saw a physician high in competence rated the likelihood of a serious disease lower, rated the likelihood of bowel cancer lower, reported less emotional concern, and expressed less desire to seek another physician's opinion or to undergo a colonoscopy. Warmth produced the same pattern at a smaller magnitude.

Researchers also examined a psychological mechanism called cognitive immunization, known as the tendency to discount information that contradicts an existing belief, as a pathway through which the physician's behavior shapes how patients perceive the information they receive. Patients were inclined to question the validity of the diagnostic information if the physician showed low competence compared with high competence, and to a lesser extent also if the physician showed low warmth compared with high warmth. A mediation analysis indicated that this cognitive devaluation accounted for the effects of both warmth and competence.

"Thus, it appears from a patient's perspective, diagnostic information presented by a doctor does not speak for itself," the authors write. "Rather, a warm and competent doctor is needed for patients to integrate the medical information and put trust in it."

The findings show that modulation of a physician's behavior directly influences how patients evaluate diagnostic information and suggest that high warmth and competence when communicating normal test results may help patients worry less, feel less inclined to seek the opinions of other doctors, and feel more reassured.

Article Cited:

Influence of Physician Behaviors on How Patients Interpret Normal Test Results

Tobias Kube, PhD, and Anna Seewald, PhD

Funding Support: Funded by a Junior Research Grant from the RPTU University of Kaiserslautern-Landau

Annals of Family Medicine is an open access, peer-reviewed, indexed research journal that provides a cross-disciplinary forum for new, evidence-based information affecting the primary care disciplines. Launched in May 2003, Annals of Family Medicine is sponsored by six family medical organizations, including the American Academy of Family Physicians, the American Board of Family Medicine, the Society of Teachers of Family Medicine, the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors, and the North American Primary Care Research Group. Annals of Family Medicine is published online six times each year, charges no fee for publication, and contains original research from the clinical, biomedical, social, and health services areas, as well as contributions on methodology and theory, selected reviews, essays, and editorials. Complete editorial content and interactive discussion groups for each published article can be accessed for free on the journal's website, www.AnnFamMed.org.

SOURCE Annals of Family Medicine