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

Patient Educ Couns. 2014 Sep;96(3):339-45. doi: 10.1016/j.pec.2014.05.006. Epub 2014 May 14.

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.

Keywords: Analogue patients; Depression; Gender concordance; Patient-centeredness; Patient–physician communication; RIAS.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Communication*
  • Depression / psychology*
  • Female
  • Gender Identity
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Patient-Centered Care*
  • Physician-Patient Relations
  • Self Disclosure*
  • Sex Factors*
  • Socioeconomic Factors
  • Videotape Recording
  • Young Adult