Asymmetrical Talk between Physicians and Patients: A Quantitative Discourse Analysis

Abstract

This study examined the discursive dynamics between physicians and patients in order to understand associations between physicians’ communication patterns and patient satisfaction. Fieldwork was conducted in a clinic in northern British Columbia. Thirty-one physician-patient consultations were audiotaped, and follow-up questionnaires on satisfaction were filled out by patients. The Roter Interaction Analysis System was used to examine nine categories of talk. Our study confirmed previous assertions that physicians’ and patients’ talk patterns are highly asymmetrical. Physicians controlled the medical consultation by asking more questions than patients, and patients did not necessarily appreciate this type of communication. Male physicians tended to make more facilitative remarks when interviewing female than male patients, which was negatively correlated with patient satisfaction.