Caring and dominance affect participants' perceptions and behaviors during a virtual medical visit

J Gen Intern Med. 2008 May;23(5):523-7. doi: 10.1007/s11606-008-0512-5. Epub 2008 Feb 8.


Background: Physician communication style affects patients' perceptions and behaviors. Two aspects of physician communication style, caring and dominance, are often related in that a high caring physician is usually not dominant and vice versa.

Objective: This research was aimed at testing the sole or joint impact of physician caring and physician dominance on participant perceptions and behavior during the medical visit.

Participants and design: In an experimental design, analog patients (APs) (167 university students) interacted with a computer-generated virtual physician on a computer screen. Participants were randomly assigned to 1 of 4 experimental conditions (physician communication style: high dominance and low caring, high dominance and high caring, low dominance and low caring, or low dominance and high caring). The APs' verbal and nonverbal behavior during the visit as well as their perception of the virtual physician were assessed.

Results: Analog patients were able to distinguish dominance and caring dimensions of the virtual physician's communication. Moreover, APs provided less medical information, spoke less, and agreed more when interacting with a high-dominant compared to a low-dominant physician. They also talked more about emotions and were quicker in taking their turn to speak when interacting with a high-caring compared to a low-caring physician.

Conclusions: Dominant and caring physicians elicit different emotional and behavioral responses from APs. Physician dominance reduces patient engagement in the medical dialog and produces submissiveness, whereas physician caring increases patient emotionality.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Empathy
  • Female
  • Humans
  • Male
  • Nonverbal Communication
  • Patient Satisfaction*
  • Perception
  • Physician-Patient Relations*
  • Social Dominance
  • Telemedicine*
  • User-Computer Interface*