Verbal analysis of doctor-patient communication

A microscopic analysis of doctor-patient communication in the general practitioner's surgery is presented. Verbatim transcripts of 85 medical interviews, audiotaped in a natural situation were analysed. The effects of type of complaint, patient gender and physician gender on the process of verbal communication were assessed. This study focused upon the relational aspects of communication, using Stiles' Verbal Response Mode coding system (VRM), and, to a limited extent, upon the content of patient's complaints--whether they were primarily somatic or of a psychosocial nature. The hypothesis of an asymmetrical relation between physician and patient was confirmed. Results partially confirmed the hypothesis that interviews of psychosocial patients take more time than those of somatic patients. There was also some evidence that psychosocial patients try to exert more control over the conversation as compared to somatic patients. Male and female patients differed in the way they elaborated their complaints. When telling their complaints, women referred more to persons (family, friends, colleagues) than did men. In case of male GP's, the interviews of female patients took more time than those of male patients. The largest differences were between male and female physicians. In agreement with the hypothesis males were more imposing and presumptuous (giving more advisements and interpretations). Female GP's were more attentive and non-directive (giving more subjective and objective information and acknowledgements). The medical interviews of female GP's took more time than the interviews of their male colleagues. The results are discussed in the light of theoretical concepts of harmony and discrepancy with respect to doctor-patient communication and theories about gender differences.doctor-patient communication conversation analysis gender differences somatization disorders