Women doctors are better communicators

BMJ 2002; 325 doi: (Published 24 August 2002) Cite this as: BMJ 2002;325:408
  1. Janice Hopkins Tanne
  1. New York

    Women doctors in the United States spend more time with their patients, talk with them more, establish more emotional rapport, and involve patients more in their treatment than male doctors, says a meta-analysis by researchers at Johns Hopkins Bloomberg School of Public Health in Baltimore and Northeastern University in Boston.

    “The most important consequence of the difference is what it inspires in patients responding back to the doctor,” said lead author Dr Debra Roter a public health specialist at Johns Hopkins. “They are more forthcoming, they talk about sensitive topics, and the physician gains more information. The medical dialogue is two way.”

    The study, published in JAMA (2002;288:756-64) analysed 23 observational studies of communication between doctors and patients and three large studies based on doctors' own reports. Together the studies included about 900 physicians, interns, residents, and medical students and more than 3700 patients. Physicians were in what are considered primary care specialties in the United States: internal medicine, family practice, general practice, paediatrics, and obstetrics and gynaecology. Patients in some studies were all women. In other studies patients were women seeking paediatric care for male and female children. Some studies had male and female patients, but no study had only male patients. The studies did not address patients' outcomes.

    The analysis covered information giving, the content and form of questions, building a partnership between doctor and patient, social conversation (non-medical pleasantries), positive talk (reassurance, agreement, encouragement), negative talk (criticism, disapproval), emotionally focused talk (asking about feelings and emotions, exploring emotional concerns, and expressing empathy or concern), non-verbal communication (smiles, nods, gestures, tone of voice), and length of visit.

    Co-author Dr Judith Hall, a psychologist at Northeastern University, said, “Patient centred medicine is the thing in primary care today. Communication skills are not trivial. They can make a big difference in patient care and outcomes such as compliance [with medication or instructions] and patient satisfaction.”

    Female doctors spent an average of 23 minutes with a patient, compared with 21 minutes for male doctors. They also talked more about psychosocial issues, gave more positive talk, and more actively sought patient input. However, the sexes did not differ in giving biomedical information about diagnosis, prognosis, and treatment. A separate meta-analysis, indicates that patients respond in a similar way to their doctor's attitude: “Like female physicians, their patients talk more overall, make more positive statements, discuss more psycho-social information, and express more partnership building than patients of male physicians.”

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    Women doctors establish emotional rapport


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