Surgeons' tone of voice: A clue to malpractice history

Ambady, Nalini; LaPlante, Debi A.; Nguyen, Thai T.; Rosenthal, Robert; Chaumeton, Nigel R.; Levinson, Wendy

doi:10.1067/msy.2002.124733

Cited by 377 publications

(197 citation statements)

References 26 publications

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“…As has been done in similar studies (Ambady, Laplante, Nguyen, Rosenthal, Chaumeton & Levinson, 2002;Harrigan, Gramata, Lucic & Margolis, 1989), the coders' global affect ratings were initially subjected to factor analyses to reduce the number of variables and create composite measures of physician and patient affective communication. The same was done to the items assessing physician perceptions of the patient as a communicator since we did not assume this was a unidimensional scale.…”

Section: Discussionmentioning

confidence: 99%

Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor?

Street

Gordon

Haidet

2007

Social Science & Medicine

442

359

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Although physicians' communication style and perceptions affect outcomes, few studies have examined how these perceptions relate to the way physicians communicate with patients. Moreover, while any number of factors may affect the communication process, few studies have analyzed these effects collectively in order to identify the most powerful influences on physician communication and perceptions. Adopting an ecological approach, this investigation examined: (a) the relationships of physicians' patient-centered communication (informative, supportive, partnership-building) and affect (positive, contentious) on their perceptions of the patient, and (b) the degree to which communication and perceptions were affected by the physicians' characteristics, patients' demographic characteristics, physician-patient concordance, and the patient's communication. Physicians (N = 29) and patients (N = 207) from 10 outpatient settings in the United States participated in the study. From audio-recordings of these visits, coders rated the physicians' communication and affect as well as the patients' participation and affect. Doctors were more patientcentered with patients they perceived as better communicators, more satisfied, and more likely to adhere. Physicians displayed more patient-centered communication and more favorably perceived patients who expressed positive affect, were more involved, and who were less contentious. Physicians were more contentious with black patients, whom they also perceived as less effective communicators and less satisfied. Finally, physicians who reported a patient-centered orientation to the doctor-patient relationship also were more patient-centered in their communication. The results suggest that reciprocity and mutual influence have a strong effect on these interactions in that more positive (or negative) communication from one participant leads to similar responses from the other. Physicians' encounters with black patients revealed communicative difficulties that may lower quality of care for these patients.

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Section: Discussionmentioning

confidence: 99%

Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor?

Street

Gordon

Haidet

2007

Social Science & Medicine

442

359

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“…Ambady et al investigated the relationship between judgements of surgeons' voice tone and their malpractice claims history. 10 Compared with surgeons with no claims, assessors correctly identified surgeons with previous claims by rating the higher dominance and lower concern for the patient revealed in the surgeon's tone of voice.…”

Section: Physician Behaviour Patterns and Patient Complaints And Litimentioning

confidence: 99%

Physician professional behaviour affects outcomes: A framework for teaching professionalism during anesthesia residency

Bahaziq

Crosby

2011

Can J Anesth/J Can Anesth

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Purpose In this review, we examine the association between physician professional behaviour and indicators measuring patient outcomes and satisfaction with care as well the potential for complaints, discipline, and litigation against physicians. We also review issues related to the structured teaching of professionalism to anesthesia residents, including resident evaluation. Source A search of the OVID Medline and PubMed databases was carried out using keywords relevant to the topics under consideration. Program directors of Canadian anesthesiology training programs were also surveyed to assess the current state of professionalism training and evaluation in their programs. Principal findings Unprofessional behaviour is frequently manifested in practice by medical students, residents, and physicians, and it is associated with personality characteristics that are evident early in training. There is a correlation between unprofessional physician behaviours and patient dissatisfaction, complaints, and lawsuits as well as adverse outcomes of care. Physician health and workplace relationships are negatively impacted by such behaviours. Canadian program directors recognize the need to approach the teaching of professionalism in an organized fashion during physician training. Conclusions A framework is provided for defining behavioural expectations, and mechanisms are offered for teaching and evaluating behaviours and responding to individuals with behaviours that persistently breach defined expectations. There is a need to define explicitly not only the expectations for behaviour but also the processes by which the behaviours will be assessed and documented. In addition, emphasis is placed on the nature, order, and magnitude of the responses to behaviours that do not meet expectations.

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“…Female physicians differ in their communication style from male physicians in very much the same way the sex difference is evident in the normal population. Roter et al [3] showed in their meta-analysis that although there is no difference in the amount of information given to patients between female and male www.elsevier.com/locate/pateducou Patient Education and Counseling 68 (2007) [16][17][18][19][20][21][22] physicians, female physicians have more positive talk (e.g., reassurance, encouragement), show more partnership building behaviors (e.g., eliciting rationale for visit and shared decision making), ask more psychosocial questions (e.g., how the disease affects the patient's daily activities), and focus more on emotions (e.g., empathy, eliciting patient concerns).…”

Section: Physician Sex and Physician Communicationmentioning

confidence: 99%

“…For instance, patients are less satisfied with a dominant physician than with a non-dominant physician [17,18]. In the same vein, primary care physicians who were never sued by patients were found to adopt a less dominant interaction style than physicians who were sued [19,20]. Physicians who were never sued encouraged patients to voice their opinions, encouraged patients to talk, and informed patients about the structure of the visit [20].…”

Section: Physician Sex and Physician Communicationmentioning

confidence: 99%

Disentangling physician sex and physician communication style: Their effects on patient satisfaction in a virtual medical visit

Mast¹,

Hall²,

Roter³

2007

Patient Education and Counseling

138

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Objective: The present study aimed to investigate the effect of physician sex and physician communication style on patient satisfaction. In real medical visits, physician sex and physician communication style are confounded variables. By using the virtual medical visit paradigm, we were able to disentangle the two variables and study their separate and/or joint effects on patient satisfaction. Method: In an experimental design, analogue patients (167 students) interacted with a computer-generated virtual physician on a computer screen. The patients' satisfaction during the visit was assessed. Results: Depending on the sex composition of the dyad, physician communication style affected analogue patients' satisfaction differently. For instance, in male-male dyads, physician communication style did not affect the patients' satisfaction, whereas in female-female dyads, analogue patients were more satisfied when the physician adopted a caring as opposed to a non-caring communication style. Conclusion: Sex of the physician and sex of the patient moderate how different physician communication styles affect patient satisfaction. In particular, a female-sex role congruent communication style leads to higher patient satisfaction when women see a female physician. Practice implications: Physician communication training cannot be one size fits all. Rather female and male physicians should obtain different training and they need to be made aware of the fact that female and male patients harbor different expectations toward them. #

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Surgeons' tone of voice: A clue to malpractice history

Cited by 377 publications

References 26 publications

Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor?

Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor?

Physician professional behaviour affects outcomes: A framework for teaching professionalism during anesthesia residency

Disentangling physician sex and physician communication style: Their effects on patient satisfaction in a virtual medical visit

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