The relation of physician and patient gender to verbal and nonverbal communication was examined in 100 routine medical visits. Female physicians conducted longer visits, made more positive statements, made more partnership statements, asked more questions, made more back-channel responses, and smiled and nodded more. Patients made more partnership statements and gave more medical information to female physicians. The combinations of female physician-female patient and female physician-male patient received special attention in planned contrasts. These combinations showed distinctive patterns of physician and patient behavior, especially in nonverbal communication. We discuss the relation of the results to gender differences in nonclinical settings, role strains in medical visits, and current trends in medical education.

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Employers who are developing strategies to reduce health-related productivity loss may benefit from aiming their interventions at the employees who need them most. We determined whether depression's negative productivity impact varied with the type of work employees performed. Subjects (246 with depression and 143 controls) answered the Work Limitations Questionnaire and additional work questions. Occupational requirements were measured objectively. In multiple regression analyses, productivity was most influenced by depression severity (P < 0.01 in 5/5 models). However, certain occupations also significantly increased employee vulnerability to productivity loss. Losses increased when employees had occupations requiring proficiency in decision-making and communication and/or frequent customer contact (P < 0.05 in 3/5 models). The Work Limitations Questionnaire can help employers to reduce productivity loss by identifying health and productivity improvement priorities.A wealth of research now shows that depression can exact a heavy economic toll on businesses and their employees. [1][2][3][4] Depression in the working-age population is estimated to cost this nation at least $12.4 billion annually in medical care and at least another $44 billion annually in lost productive work time. 4,5 Researchers estimate that approximately half of the employers' total costs for depression are the result of employee work absences and disability claims. 3 One of the main reasons for these staggering costs is that one in eight working-age adults, 18 to 54 years of age, is estimated to be clinically depressed, and half will experience a recurrence within 1 year of remission. 6 Employers have relied mainly on medical care for help in treating their employees' depression. By doing so, some companies have hoped to minimize the condition's secondary Copyright © by American College of Occupational and Environmental Medicine Address correspondence to: Debra Lerner, MS, PhD, The Health Institute, Tufts-New England Medical Center, 750 Washington Street, NEMC #345, Boston, MA 02111; dlerner@tufts-nemc.org.. NIH Public AccessAuthor Manuscript J Occup Environ Med. Author manuscript; available in PMC 2015 January 05. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript impact on employee work performance and productivity. There is some rationale for this approach. In addition to the depression impact studies cited previously, 1-4 studies suggest that patients whose symptoms improve subsequently have less work impairment. [7][8][9][10] Recently, a few treatment trials have found that compared with patients receiving usual care, those getting high-quality depression treatment have fewer work absences and less unemployment (Rost K, Smith JL, Elliott CE, Dickinson M, Duan N, submitted). 11In previous depression research, productivity loss has been included as a secondary outcome and few explanatory variables, other than depression symptoms or depression treatment, were included. This study addresses productivity loss...