Dyadic concordance in physician-patient interactions can be defined as the extent of agreement between physicians and patients in their perceptions of the clinical encounter. The current research specifically examined two types of concordance: informational concordance-the extent of agreement in physician and patient responses regarding patient information (education, self-rated health, pain); and interactional concordance-the extent of physician-patient agreement regarding the patient's level of confidence and trust in the physician and the perceived quality of explanations concerning diagnosis and treatment. Using a convenience sample of physicians and patients (N = 50 dyads), a paired survey method was tested, which measured and compared physician and patient reports to identify informational and interactional concordances. Factors potentially related to dyadic concordance were also measured, including demographic characteristics (patient race, gender, age, and education) and clinical factors (whether this was a first visit and physician specialty in family medicine or oncology). The paired survey showed informational discordances, as physicians tended to underestimate patients' pain and overestimate patient education. Interactional discordances included overestimating patients' understanding of diagnosis and treatment explanations and patients' level of confidence and trust. Discordances were linked to patient dissatisfaction with physician listening, having unanswered questions, and feeling the physician had not spent enough time. The paired survey method effectively identified physician-patient discordances that may interfere with effective medical practice; this method may be used in various settings to identify potential areas of improvement in health communication and education.

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Listening has been reported to be an important component in judgments of communication competence in the workplace. To investigate the contributions of listening to judgments of competence, this study examined how organization members use listening and listening-related factors in judgments of communication competence across situations. The results support the notion that listening plays a central role in assessments of communication competence. Analysis reveals that listening accounts for approximately one-third of the characteristics perceivers use to evaluate communication competence in co-workers. Additionally, the results suggest organization members differ in their use of listening in judgments of competence in several kinds of situations.Scholars from a variety of disciplines have claimed that communication competence is central to effective functioning in organizations ) have observed that individuals commonly use listening or listening-related factors such as empathy to evaluate the communication competence of others. With employees engaged in some form of communication during much of their day, evaluations of the listening and speaking skills of co-workers are inevitable. Organization members frequently find themselves in situations asking questions such as: Does this person understand my position ? Will this person recall what I'm saying? Is this manager willing to hear me out? Why can't this employee listen to others? How perceivers incorporate listening factors into judgments of the communication competence of co-workers has been the focus of recent interest (Brownell, 1990; Cooper & Husband, 1993; Monge, Bachman, Dillard, & Eisenberg, 1982). As Brownell (1990) suggests, this interest is driven by the need to more precisely determine how employees perceive and evaluate the behaviors of others. For example, Monge et al. (1982) argue that individuals employ two dimensions in making competence judgments of co-workers: encoding and decoding. Others, such as Papa and Tracy (1988) report that perceivers evaluate the competence of others along a single dimension that unites speaking and listening skills. However, other scholars (e.g., Brownell, 1990; Cooper & Husband, 1993) separate listening-related factors from speaking factors in judgments of competence at UNIV OF MICHIGAN on June 26, 2015 job.sagepub.com Downloaded from

By extending Millar and Roger's (1976) relational theory, this study examined how the physician-patient relationship was negotiated in the context of a clinical visit. Analysis of observational data obtained during the clinical visits of 1 female family practice physician revealed 5 themes central to the construction of her relationships with patients. The 5 themes included control, role negotiation, trust, health care commitment, and interrelated issues of time and money.