Hostile Sexist Male Patients and Female Doctors: A Challenging Encounter
- 172 Downloads
Patient characteristics and attitudes can affect how patients react to the physician’s communication style, and this reaction can then influence consultation outcomes.
The goal of the present study was to investigate whether the attitude of a sexist male patient affects how he perceives a female physician’s nonverbal communication and whether this then results in expecting less positive consultation outcomes.
Study design and setting
Participants were analog patients who viewed four videotaped male and four videotaped female physicians in a consultation with one of their patients. Physician videos were preselected to represent a range of high and low patient-centered physician nonverbal behavior. Participants filled in questionnaires to assess how patient-centered they perceived the female and male physicians’ nonverbal communication to be, and participants indicated how positive they expected the consultation outcomes to be. Moreover, we assessed the participants’ sexist attitudes with a questionnaire measuring hostile and benevolent sexism.
Students (N = 60) from a French-speaking university in Switzerland were recruited on campus.
Main outcome measure
The main outcome measures were the extent to which analog patients expect the consultation outcomes to be positive (high satisfaction, increased trust in the physician, intention to adhere to treatment recommendations, and perceived physician competence) and the extent to which analog patients perceive physicians as patient-centered (judged from the physicians’ nonverbal cues).
Male analog patients’ hostile sexism was negatively related to perceiving the physicians as patient-centered, and male analog patients’ hostile sexism was also negatively related to expected positive consultation outcomes. For male patients viewing female physicians, mediation analysis revealed that perceived physician patient-centeredness mediated the negative relationship between hostile sexism and expected positive consultation outcomes.
Male hostile sexist patients perceive a female physician’s nonverbal communication as less patient-centered and this negatively affects their expectation of positive outcomes from the consultation.
KeywordsSexist Attitude Nonverbal Behavior Benevolent Sexism Female Physician Hostile Sexism
Acknowledgments and funding
The authors thank Gaëtan Cousin for his comments on an earlier version of this manuscript. The research findings have been presented at the International Conference on Communication in Healthcare 2010 in Verona. This research has been supported by a grant from the Swiss National Science Foundation (PP0001-106528/1) to the second author.
Conflicts of interest and guarantor statement
We, Christina Klöckner Cronauer and Marianne Schmid Mast, certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript. Both authors have sufficiently participated in the planning of this study, acquisition, analysis, and interpretation of data, as well as the drafting and reviewing process of this article, and therefore are equal guarantors for the overall content.
- 3.Stewart MA. Effective physician-patient communication and health outcomes: a review. Can Med Assoc J. 1995;152:1423–33.Google Scholar
- 4.Schmid Mast M, Hall JA, Roter DL. Disentangling physician gender and communication style effects on patient satisfaction and behavior in a virtual medical visit. Patient Educ Couns. 2007;3:1–28.Google Scholar
- 9.DiMatteo MR, Hays RD, Prince LM. Relationship of physicians’ nonverbal communication skills and standardized patient satisfaction. J Gen Intern Med. 1986;18:170–4.Google Scholar
- 14.Ende J, Kazis L, Ash A, Moskowitz MA. Measuring patients’ desire for autonomy: decision making and information-seeking preferences among medical patients. J Intern Med. 1989;4:23–30.Google Scholar
- 21.Cousin G, Schmid Mast M, Jaunin-Stalder N. When physician expressed uncertainty leads to patient dissatisfaction: a gender study. Med Educ. 2013;47(9):923-31.Google Scholar
- 22.Roter DL, Hall JA. Doctors talking with patients/patients talking with doctors: improving communication in medical visits. Westport: Auburn House/Greenwood Publishing Group, Inc; 1992.Google Scholar
- 25.Schmid Mast M. On the importance of nonverbal communication in the physician–patient interaction. Patient Educ Couns. 2007;67:315–8.Google Scholar
- 33.Schmid Mast M, Kindlimann A, Langewitz W. Recipient’s perspective on breaking bad news: how you put it really make a difference. Patient Educ Couns. 2005;58:244–51.Google Scholar
- 34.Schmid Mast M, Hall JA, Klöckner C, Choi E. Physician gender affects how physician nonverbal behavior is related to patient satisfaction. Med Care. 2008;46:1212–8.Google Scholar
- 45.Delgado A, Lopez-Fernandez LA, Luna Jde D, Saletti-Cuesta L, Gil N, Jimenez M. The role of expectations in preferences of patients for a female or male general practitioner. Patient Educ Couns. 2011;82(1):49–57. doi: 10.1016/j.pec.2010.02.028.
- 47.Rosenthal GE, Sahnnon SE. The use of patient perceptions in the evaluation of health-care delivery systems. Med Care. 1997;35(11):NS58–68.Google Scholar
- 48.van Vliet LM, van der Wall E, Albada A, Spreeuwenberg PM, Verheul W, Bensing JM. The validity of using analogue patients in practitioner–patient communication research: Systematic review and meta-analysis. J Gen Intern Med. 2012;27:1528–43. doi: 10.1007/s11606-012-2111-8.PubMedCentralPubMedCrossRefGoogle Scholar