ORIGINAL RESEARCH Clinical Setting Influences Patterns of Interaction between Osteoporosis Patient and Physician Andrea Ildiko Gasparik Received: 10 April 2014 / Accepted: 9 May 2014 Ó Springer Science+Business Media New York 2014 Abstract The importance of healthy behavior for bone health, as well as low adherence to anti-osteoporosis medication are well-described problems. Both, lifestyle habits and compliance with drug-therapy are influenced by the relationship between patients and physicians. We ana- lyzed 152 consecutive doctor–patient interactions con- ducted in public and private practices specialized in the management of osteoporosis. We recorded the duration of the consultation and the relative length of: (a) Personal and medical history collection, (b) Physical examination, (c) Explanation of the diagnosis and treatment modalities, and (d) Administrative tasks. The overall length and the respective duration of the four phases of the consultation significantly differ in private versus public practices. In the private practice, doctors spend more time with the patient and dedicate a higher proportion of their time to history collection and explanation of diagnosis/treatment for osteoporosis. While we do not integrate data on medication adherence, we believe that since more time is dedicated to health education, patients consulting in the private sector have a greater probability to adopt a healthy lifestyle and better/ longer take anti-osteoporosis medications. Further investigations are needed to assess if the differences in patient and doctor behaviors in the public–private settings have a significant impact on therapeutic adherence and subsequently fracture reduction in patients receiving anti- osteoporosis treatment. Keywords Doctor–patient interaction Á Adherence Á Private Á Public Á Osteoporosis Introduction The importance of healthy behavior: regular exercise, adequate diet, and avoiding harmful habits are crucial for slowing the progression of osteoporosis. Poor compliance and persistence are also common problems in the treat- ment of silent chronic disorders, including osteoporosis (OP) [1]. Poor adherence reduces the effectiveness of OP treatments, resulting in lower bone mineral density gain and subsequent higher fracture rates [2]. The studies addressing compliance and persistence have shown that both aspects of adherence are important drivers of medications cost-effectiveness [3]. Both, patient and medication factors are involved in adherence to therapy [4]. However, management of low adherence strategies consistently point out the positive impact of an improved relationship between patients and physicians, the latter providing adequate intake instructions, edu- cation, feedback, and support [5]. Several factors influence patients’ trust and trust influences the doctor– patient relationship [6]. Trust mediates positive out- comes including adherence to treatment and satisfaction [7]. Recent studies revealed that patients trust their primary care physician (GP) to a high extent by relying on simple signals that are based on the quality of the one-to-one communication and on behavioral and rela- tional patterns [6]. The objective of the present trial is to explore the con- tent of a first encounter between patients seeking infor- mation, diagnosis, or treatment for OP and ‘‘bone doctors’’. We also assessed whether the interaction between service provider (i.e., physician) and customer (i.e., patient) is influenced by the nature (i.e., public versus private) of the medical institution where the medical service is rendered. A. I. Gasparik (&) University of Medicine and Pharmacy Tg. Mures, UMF. Tirgu Mures, Str Gh. Marinescu nr. 38, 540139 Ta ˆrgu Mures ¸, Romania e-mail: ildikogasparik@gmail.com 123 Calcif Tissue Int DOI 10.1007/s00223-014-9869-0