When the Doctor Is a “Lady”: Power, Status and Gender in Physician‐patient Encounters*

Abstract

An extensive body of research indicates that men interrupt women much more often than the reverse, across a variety of situations. Some conclude that men's interruptions of women in cross‐sex conversations constitute an exercise of power and dominance over their conversational partners. To be sure, power is an important facet of many other social relationships, such as those between whites and Blacks, bosses and employees, and—of immediate interest—doctors and patients. Moreover, much of our existing knowledge of sex differences in behavior confounds gender with status. This paper reports results of an exploratory study of interruptions between physicians and patients during actual “visits to the doctor.” Findings based on detailed analyses of videotaped encounters offer empirical support for an asymmetrical view of the physician‐patient relationship: physicians interrupt patients disproportionately—except when the doctor is a “lady.” Then, patients interrupt as much or more than physicians, and their interruptions seem to subvert physicians' authority. Discussion focuses on the respective roles of power, status and gender in face‐to‐face interaction.

Sex and Power in Interaction: Conversational Privileges and Duties

“…Zimmerman and West felt that the differences among cross-sex dyads were reflections of the power and dominance enjoyed by men in society, and in a subsequent study (West and Zimmerman, 1977) found the same sort of marked asymmetry in rates of interruptions among adult-child dyads, thereby giving further credence to the idea that the differences were tied to status. The notion that interruptions are a form of dominance is also supported in the work of Courtright et al (1979), Eakins and Eakins (1978), Rogers and Jones (1975), and West (1984).…”

Physician–patient interaction: a gynecology clinic in Turkey

“…More generally, male physicians were more directive and informative than female physicians (Meeuwesen, Schaap, & Van der Staak, 1991), and also tended to interrupt their patients more frequently (West, 1998). Female physicians were more positive (Roter, Lipkin, & Korsgaard, 1991), more empathic (Wasserman, Inui, Barriatua, Carter, & Lippincott, 1984) and more focused on emotions (Mendez, Shymansky, & Wolrach, 1986) than male physicians.…”

“…In one study, male physicians were more likely to speak in an authoritarian manner, use explicit commands when giving instructions to the patients, and ask more direct questions, when compared to female physicians (West, 1993). In contrast, female physicians were more likely to give their instructions and directives as proposals, engaging the patient in a more balanced relationship and partnership building (asking for opinion, understanding, paraphrasing and interpreting), when compared to male physicians.More generally, male physicians were more directive and informative than female physicians (Meeuwesen, Schaap, & Van der Staak, 1991), and also tended to interrupt their patients more frequently (West, 1998). Female physicians were more positive (Roter, Lipkin, & Korsgaard, 1991), more empathic (Wasserman, Inui, Barriatua, Carter, & Lippincott, 1984) and more focused on emotions (Mendez, Shymansky, & Wolrach, 1986) than male physicians.…”

Analyzing Efl Classroom Talk During Class Opening: Topic Shift and Negotiation

“…Several researchers (Holmes 2000, Holmes & Stubbe 2003, Mayr 2008, Mumby 1988, Thornborrow 2002, Vine 2004, West 1984, 1990, 1998 who center their studies on interaction in the institutional context, reveal that such interaction always involves power; one party having more power than others. Power infl uences not only how language is used, but also how talk should be designed, organized, delivered, and interpreted during social interaction.…”