Abstract
BACKGROUND
Physician communication style affects patients’ perceptions and behaviors. Two aspects of physician communication style, caring and dominance, are often related in that a high caring physician is usually not dominant and vice versa.
OBJECTIVE
This research was aimed at testing the sole or joint impact of physician caring and physician dominance on participant perceptions and behavior during the medical visit.
PARTICIPANTS AND DESIGN
In an experimental design, analog patients (APs) (167 university students) interacted with a computer-generated virtual physician on a computer screen. Participants were randomly assigned to 1 of 4 experimental conditions (physician communication style: high dominance and low caring, high dominance and high caring, low dominance and low caring, or low dominance and high caring). The APs’ verbal and nonverbal behavior during the visit as well as their perception of the virtual physician were assessed.
RESULTS
Analog patients were able to distinguish dominance and caring dimensions of the virtual physician’s communication. Moreover, APs provided less medical information, spoke less, and agreed more when interacting with a high-dominant compared to a low-dominant physician. They also talked more about emotions and were quicker in taking their turn to speak when interacting with a high-caring compared to a low-caring physician.
CONCLUSIONS
Dominant and caring physicians elicit different emotional and behavioral responses from APs. Physician dominance reduces patient engagement in the medical dialog and produces submissiveness, whereas physician caring increases patient emotionality.
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Acknowledgments
This research was supported by a grant from the University of Zurich and by a grant from the Swiss National Science Foundation (PP001-106528/1) to the first author. Parts of the data were presented at the International Conference on Communication in Healthcare 2006 in Basel, Switzerland. We thank Claudia Dietz, Nadine Steurer, Anja Barizzi, Andrea Luomajoki-Stierli, Nadja Abt, Evelyn Mosimann, and Florinda Zagaria for their help in data collection and coding. The virtual consultation room and the virtual physician were created through an Swiss National Science Foundation fellowship awarded to the first author.
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The following table displays the physician communication scripts varying in emotionality (high versus low) and in dominance (low versus high). The left side of the table shows the scripts for high emotionality and the right side of the table shows the scripts for the low emotionality. High and low emotionality each branch off on the right to low dominance and on the left to high dominance. The column in the middle indicates identical text for both low and high dominance conditions. The statements of the different conditions are on the same line.
ESM Table
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Schmid Mast, M., Hall, J.A. & Roter, D.L. Caring and Dominance Affect Participants’ Perceptions and Behaviors During a Virtual Medical Visit. J GEN INTERN MED 23, 523–527 (2008). https://doi.org/10.1007/s11606-008-0512-5
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DOI: https://doi.org/10.1007/s11606-008-0512-5