Talking about depression: an analogue study of physician gender and communication style on patient disclosures

Debra L. Roter, Lori H. Erby, Ann Adams, Christopher D. Buckingham, Laura Vail, Alba Realpe, Susan Larson, Judith A. Hall

Research output: Contribution to journalArticle

Abstract

Objectives: To disentangle the effects of physician gender and patient-centered communication style on patients' oral engagement in depression care. Methods: Physician gender, physician race and communication style (high patient-centered (HPC) and low patient-centered (LPC)) were manipulated and presented as videotaped actors within a computer simulated medical visit to assess effects on analogue patient (AP) verbal responsiveness and care ratings. 307 APs (56% female; 70% African American) were randomly assigned to conditions and instructed to verbally respond to depression-related questions and indicate willingness to continue care. Disclosures were coded using Roter Interaction Analysis System (RIAS). Results: Both male and female APs talked more overall and conveyed more psychosocial and emotional talk to HPC gender discordant doctors (all p <.05). APs were more willing to continue treatment with gender-discordant HPC physicians (p <.05). No effects were evident in the LPC condition. Conclusions: Findings highlight a role for physician gender when considering active patient engagement in patient-centered depression care. This pattern suggests that there may be largely under-appreciated and consequential effects associated with patient expectations in regard to physician gender that these differ by patient gender. Practice implications: High patient-centeredness increases active patient engagement in depression care especially in gender discordant dyads.
Original languageEnglish
Pages (from-to)339–345
Number of pages7
JournalPatient Education and Counseling
Volume96
Issue number3
Early online date14 May 2014
DOIs
Publication statusPublished - Sep 2014
EventInternational Conference on Communication in Healthcare - Montreal, Canada
Duration: 29 Sep 20132 Oct 2013

Bibliographical note

Communication in Healthcare: Lessons from Diversity — Best papers from the International Conference on Communication in Healthcare, Montreal, Canada, 29 September - 2 October 2013.

Funding: National Institute of Mental Health (NIMH) R01MH086339 (Debra Roter, PI) “Understanding Social Contributions to Disparities in Depression Care: US and UK”. This program of research is also funded by the Economic and Social Research Council (ESRC), grant RES-177-25-0014, which forms part of the ESRC/NIH Disparities Initiative.

Keywords

  • depression
  • patient-centeredness
  • RIAS
  • analogue patients
  • patient–physician communication
  • gender concordance

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