Intended for healthcare professionals


Dulcet tones of a surgeon's voice may have a hidden meaning

BMJ 2002; 325 doi: (Published 10 August 2002) Cite this as: BMJ 2002;325:297
  1. Roger Dobson
  1. Abergavenny

    Surgeons who speak with a dominating tone and who sound less concerned in conversation with their patients than other surgeons are more likely to have been sued for malpractice.

    In what is described as the first study to show clear links between communication and malpractice among surgeons, researchers found that sampling just a few seconds of conversations between doctors and patients was sufficient to identify doctors with a history of claims against them.

    “The present findings are novel in that they show that speech and voice tone alone, judged frommere 40 second slices of speech, can distinguish between claims and no claims surgeons. These results underscore the potency of vocal communication in medical interactions,” says the report (Surgery 2002:132:5-9).

    “It suggests new information that tone of voice rather than just content of communication may be related to surgical malpractice. These data suggest that surgeons' tone of voice in communication might be one key factor in providing satisfactory care and in avoiding lawsuits.”

    In the Harvard University study the team audiotaped surgeons speaking to their patients. The samples of conversation were then rated by 12 volunteers who were blinded to the surgeons' malpractice history.

    About half of the 65 orthopaedic and general surgeons who took part had had two or more previous malpractice claims, and half had never experienced a claim.

    Analysis of the scoring showed that surgeons who were judged to be more dominant and less concerned and anxious were more likely to have been sued than surgeons who were judged to be less dominant and more concerned and anxious.

    “These findings suggest that, in the medical encounter, how a message is conveyed may be as important as what is said,” says the report.”Dominance coupled with a lack of anxiety in the voice may imply surgeon indifference and lead a patient to launch a malpractice suit when poor outcomes occur.”

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