The Patient-Practitioner Relationship Flashcards
The factors influence the trust between a patient and their practitioner
-practitioner and patient interpersonal skills
-patient and practitioner diagnosis and style
-misusing health services
Interpersonal skills
-‘inter’ and ‘personal’ mean ‘between people’
-the abilities we have (or don’t have) that allow us to communicate effectively with others
Non-verbal communication
the message is conveyed through a person’s body language and paralinguistic features
The nonverbal communications study was performed by whom and in what year
McKinstry and Wang, 1991
What did McKinstry and Wang investigate
-doctors clothing as a form of non-verbal communication
-how acceptable different patients found different styles of doctor’s dress code and whether patients felt like the dress code influenced their respect
Sample of McKinstry and Wang’s study
475 patients, seeing 30 different doctors from five general medical centres in one area of Scotland
In the interview conducted by McKinstry and Wang’s study, what were the interviewees asked
They were asked about their opinion on eight different photographs. The images were of a male doctor or a female doctor, each dressed differently but in a similar pose.
They were asked:
* Which doctor would they feel happiest seeing for the first time (scoring 0–5)
* Whether they would have more confidence in the ability of one of these doctors (based on their appearance)
* Whether they would be unhappy about consulting any of them
* Which doctor looked most like their own doctor
*Along with a series of general, closed questions about doctors’ dress
How did the interviewer in McKinstry and Wang’s sample the patients
The interviewer sampled patients at different times of day on five occasions at each surgery, seeing on average just over 70% of available patients.
(opportunity sampling)
Results of Mckinstry and Wang’s study: which doctor would they feel happiest seeing for the first time
*patients significantly preferred male doctors wearing a formal suit and tie
*patients significantly preferred female doctors in a white lab coat, although not significantly more so than females in a smart skirt and blouse
*The preferences for traditionally dressed doctors were most apparent in older patients, and those in higher social classes
Results of Mckinstry and Wang’s study: confidence when seeing certain doctors
*64% said that the way their doctor dressed was quite or very important
*When asked about their confidence in the doctor’s ability, 41% expressed a preference for one photograph, predominantly the formally dressed ones (although nine had most confidence in the male doctor in jeans and 13 in the female doctor in trousers)
Results of Mckinstry and Wang’s study: Which doctor looked most like their own doctor
*The data about the similarity to the patient’s own doctor was difficult to analyse as some patients did not respond or gave two answers.
*However, many more patients in one practice said their doctor looked most like the smartly dressed one, while in another few did.
*This difference was reflected in
their choices, with those having a formally dressed doctor preferring one dressed like that
Results of Mckinstry and Wang’s study: whether they would be unhappy about consulting any of them
*Although 28% of patients reported that they would be unhappy seeing one of the doctors shown, usually the informally dressed one, some patients said they disliked their doctor wearing a white lab coat
*higher social classes objected more to male doctors wearing an earring and to female doctors wearing lots of jewellery
Results of Mckinstry and Wang’s study in general
*only gender difference with regards to patients is that: female patients ranked the male doctor in a tweed jacket higher than male patients did
*there was variation between patients from different medical centres, with some showing much stronger preferences for a male doctor in a suit and against a male doctor in jeans and others being less extreme
*more male than female patients thought that women doctors should wear white coats
Conclusions of McKinstry and Wang’s study
*In general, the findings show that patients prefer formally dressed doctors although this is somewhat affected by age, social class and the particular medical practice used
*Patients also preferred doctors dressed in the manner of their current doctor, although it may be that doctors dress according to their perception of their patients’ preferences
*The study did have low demand characteristics. This is illustrated by the findings that many patients who said they felt the way the doctor dressed was not important, still gave discriminatory scores in assessing the photographs
Improvement McKinstry and Wang could have done their study
It would have been helpful to have included a photograph of a female doctor in a formal suit, and had this been included the preference for the female in the white coat might not have been so apparent
