Gender Differences in Patient-Physician Communication

The past decade has broadened definitions of quality in medical care from adherence to narrow technical standards to include providers’ interpersonal skills in all aspects of the medical interview (Lipkin, Quill, & Napodano, 1984). Attracting the most speculation as a likely source of gender differences in the quality of care is the nature of doctor-patient communication. There has been long-standing debate on whether the content and quality of communication from female physicians provide a different therapeutic milieu from that of male physicians, one that would allow for more open exchange and ultimately more comprehensive diagnosis and treatment (Weisman & Teitelbaum, 1989). The consequences of these differences may be considerable. Recent evidence of disparities in the use of major diagnostic and therapeutic interventions for women compared with men, particularly in terms of coronary artery disease, may be a reflection of failed communication between patients and their physicians that might be partly attributable to gender (Steingart et al., 1991; Verbrugge & Steiner, 1981). The purpose of this chapter is to summarize the literature related to gender and health care communication between patients and physicians and to explore the relevance of these findings to medical practice. The potential clinical implication of these studies for individual patients is significant in terms of satisfaction, compliance with therapeutic recommendations, and, ultimately, morbidity and mortality (Roter & Hall, 1992). Although relative newcomers to the mainstream of medicine, women currently make up nearly 50% of those entering medical school. Long-standing patterns of practice and even the very philosophy of medicine, which has almost by definition been male medical practice, can be expected to change. Although this chapter is limited to research on gender and its role in patient-physician communication during routine medical visits, we hope that the discussion will encourage work on other variables likely to affect patient-physician communication, such as race or ethnicity and social class.