Physician–patient interaction: a gynecology clinic in Turkey

Abstract

Evidence for gender differences in physiciansÕ communication with their patients comes primarily from Western countries. Little is known about whether these gender differences would also be observed in Turkey, where there are explicit rules about male-female conduct. The purpose of this study was to observe male and female gynecologistsÕ communication with their patients in a gynecology clinic at a state hospital in Istanbul, Turkey. Four male and three female gynecologists were observed in their interaction with 70 patients over 10 days. The observations were conducted during both the history taking and the actual examination sessions by a woman researcher. The results reported in this paper are based on the extensive field notes taken during the observations. Important differences were revealed in interactions between male versus female gynecologists and their patients. Namely, interactions differed in terms of conversation initiation, communication style, use of technical and colloquial language, frequency of eye contact, patience, and provision of information. Communication characteristics specific to interactions between male gynecologists and their patients included a Ôblaming the victimÕ approach, differential treatment of patients, and underestimation of patientsÕ abilities. Environmental factors that affected physiciansÕ interaction with their patients are reported in conjunction with physiciansÕ use of these external factors to explain the problems they experienced in physicianpatient interaction. The discussion focuses on alternative explanations for and future research implications of the observed differences between male and female gynecologists in this setting. Keywords: physician-patient communication, gynecology clinic, TurkeyPhysician-Patient Interaction 3 Physician-patient interaction: A gynecology clinic in Turkey A consultation between a health professional and a patient is a social encounter. As in every social encounter, the gender of the participants is one determining factor in this interaction.Gender differences in communication in non-clinical settings are well documented in both psychological and sociological literature (e.g. Coates, 1986;Kramarae, 1981). Likewise, studies in clinical settings have begun to document gender differences among physicians in specialist and primary care communication (Hall, Irish, Roter, Ehrlich, & Muller, 1994a).Existing research on gender differences in physician-patient communication comes primarily from Western parts of the world. Research in this subject area has rarely been conducted in developing parts of the world where communication between men and women can be more challenging. Consequently, the research presented in this paper is an observational study conducted in a gynecology clinic at a teaching hospital in Istanbul, Turkey. The objective of this study was to describe and compare male and female gynecologistsÕ communication with their patients. The larger context in which physician-patient interaction takes place was also observed in o...

Muslim Women's Physician Preference: Beyond Obstetrics and Gynecology

“…Our findings confirm reports of Muslim women's request for same-gender physicians in O&G (Aldeen, 2007;Hammoud et al, 2005;Lafta, 2006;Rizk et al, 2005;Rizk & El-Safty, 2006;Uskul & Ahmad, 2003). That almost half of the Emirati women preferred a female physician to examine their eyes was, however, unexpected, as we considered this scenario not to be sensitive.…”

“…Much of the research investigating female patients' choice of physician relates to obstetrics and gynecology (O&G), where a global increasing preference amongst women for same-gender obstetricians and gynecologists has been reported (Adams 2003;Chandler, Chandler, & Dabbs, 2000;Lafta, 2006;Rizk, El-Zubeir, Al-Dhaheri, Al-Mansouri, & Al-Jenaib, 2005;Schnatz, Murphy, O'Sullivan, & Sorosky, 2007;Uskul & Ahmad, 2003;Zuckerman, Navizedeh, Feldman, McCalla, & Minkoff, 2002). Board certification, communication skills, professional attitude and behavior, a long-standing history with an obstetrician or gynecologist, and religion and culture are some of the many factors influencing patients' preference (Christen, Alder, & Bitzer, 2008;Piper, Shvarts, & Lurie, 2008;Rizk et al, 2005;Schnatz et al, 2007;Uskul & Ahmad, 2003;Zuckerman et al, 2002).…”

“…Board certification, communication skills, professional attitude and behavior, a long-standing history with an obstetrician or gynecologist, and religion and culture are some of the many factors influencing patients' preference (Christen, Alder, & Bitzer, 2008;Piper, Shvarts, & Lurie, 2008;Rizk et al, 2005;Schnatz et al, 2007;Uskul & Ahmad, 2003;Zuckerman et al, 2002). Schnatz and colleagues (2007) have suggested, however, that gender stereotyping may play a role in physician preference amongst female gynecological patients, as same-gender preference disappeared when the male gynecologist's technical competence or humanistic qualities was advertised.…”

“…2002) or in Islamic countries (Lafta, 2006; Downloaded by [New York University] at 00:55 06 October 2014 Rizk et al 2005;Rizk & El-Safty, 2006;Rizk, Nasser, Thomas, & Ezimokhai, 2001;Rizk, Shaheen, Thomas, Dunn, & Hassan, 1999;Uskul & Ahmad, 2003;Winslow & Honein, 2007). Thus, in contexts and communities where culture and religion are deep rooted, a same-gender practitioner is likely to be important for women, particularly for intimate examinations such as breast, obstetric, gynecological, and urogenital examinations (Aldeen, 2007;Matin & LeBaron, 2004;Rajaram & Rashidi, 1999Rizk & El-Safty, 2006;Rizk et al, 2001Rizk et al, , 2005Underwood et al, 1999;Zuckerman et al, 2002).…”

Sociología de la práctica médica autoritaria: violencia obstétrica, anticoncepción inducida y derechos reproductivos

“…Se ha documentado que tales desigualdades impactan tanto en el nivel de las políticas nacionales de salud como en las prácticas concretas de atención en los servicios de salud reproductiva (Cook, 1995;Uskul y Ahmad, 2003). Y se han desarrollado propuestas especí-ficas para evaluar en qué medida la falta de observancia de los derechos reproductivos en los servicios de salud puede ser considerada como una responsabilidad del Estado (Rahman y Pine, 1995).…”