Finding the right interactional temperature: do colder patients need more warmth in physician communication style?

Soc Sci Med. 2013 Dec;98:18-23. doi: 10.1016/j.socscimed.2013.08.034. Epub 2013 Sep 7.


Being aware of which communication style should be adopted when facing more difficult patients is important for physicians; it can help prevent patient reactions of dissatisfaction, mistrust, or non-adherence that can be detrimental to the process of care. Past research suggests that less agreeable patients are especially critical towards, and reactive to, their physician's communication style, compared to more agreeable patients. On the basis of the literature, we hypothesized that less agreeable patients would react more negatively than agreeable patients to lower levels of affiliativeness (i.e., warmth, friendliness) in the physicians, in terms of satisfaction with the physician, trust in the physician, and determination to adhere to the treatment. Thirty-six general practitioners (20 men/16 women) working in their own practice in Switzerland were filmed while interacting with 69 patients (36 men/33 women) of different ages (M = 50.7; SD = 18.19; range: 18-84) and presenting different medical problems (e.g., back pain, asthma, hypertension, diabetes). After the medical interview, patients filled in questionnaires measuring their satisfaction with the physician, their trust in the physician, their determination to adhere to the treatment, and their trait of agreeableness. Physician affiliativeness was coded on the basis of the video recordings. Physician gender and dominance, patient gender and age, as well as the gravity of the patient's medical condition were introduced as control variables in the analysis. Results confirmed our hypothesis for satisfaction and trust, but not for adherence; less agreeable patients reacted more negatively (in terms of satisfaction and trust) than agreeable patients to lower levels of affiliativeness in their physicians. This study suggests that physicians should be especially attentive to stay warm and friendly with people low in agreeableness because those patients' satisfaction and trust might be more easily lowered by a cold or distant physician communication style.

Keywords: Agreeableness; Difficult patients; Physician–Patient communication; Satisfaction; Switzerland; Trust.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Communication*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance / psychology*
  • Patient Satisfaction / statistics & numerical data*
  • Physician-Patient Relations*
  • Surveys and Questionnaires
  • Switzerland
  • Trust / psychology*
  • Videotape Recording
  • Young Adult