THE PATIENT-PHYSICIAN RELATIONSHIP Physician Gender Effects in Medical Communication A Meta-analytic Review

STUDIES HAVE LINKED PHYSICIANS’ communication skills to a variety of positive outcomes, including patient and physician satisfaction, higher levels of adherence to therapeutic recommendations, improved physiological indicators of disease control, and enhanced physical and mental health status. Within this context, gender has stimulated a good deal of interest as a possible source of variation in the interpersonal aspects of medical practice, with speculation that female physicians facilitate more open and equal exchange and a different therapeutic milieu from that of male physicians. Outside of the medical context, differences in the interpersonal style of women compared with men are well documented. Women disclose more information about themselves in conversation, they have a warmer and more engaged style of nonverbal communication, and they encourage and facilitate others to talk to them more freely and in a warmer and more intimate way. There is also evidence that women take greater pains to downplay their own status in an attempt to equalize status with a partner, in contrast with men’s tendency to assert status differences. Despite gender differences in routine conversation, it is not known whether “female-linked” conversational styles are Author Affiliations: Departments of Health Policy and Management (Dr Roter) and Environmental Health Sciences (Mr Aoki), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md; and Department of Psychology, Northeastern University, Boston, Mass (Dr Hall). Corresponding Author and Reprints: Debra L. Roter, DrPH, Johns Hopkins University, Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205 (e-mail: [email protected]). The Patient-Physician Relationship Section Editor: Richard M. Glass, MD, Deputy Editor. Context Physician gender has been viewed as a possible source of variation in the interpersonal aspects of medical practice, with speculation that female physicians facilitate more open and equal exchange and a different therapeutic milieu from that of male physicians. However, studies in this area are generally based on small samples, with conflicting results.