Debra L Roter1, Lori H Erby2, Ann Adams3, Christopher D Buckingham4, Laura Vail3, Alba Realpe3, Susan Larson2, Judith A Hall5. 1. Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA. Electronic address: droter@jhsph.edu. 2. Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA. 3. University of Warwick, UK. 4. Aston University, UK. 5. Northeastern University, USA.
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.
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.
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