Physicians' and Patients' Interruptions in Clinical Practice: A Quantitative Analysis.

PURPOSE: Physicians' interruptions have long been considered intrusive, masculine actions that inhibit patient participation, but a systematic analysis of interruptions in clinical interaction is lacking. This study aimed to examine when and how primary care physicians and patients interrupt each other during consultations. METHODS: We coded and quantitatively analyzed interruption type (cooperative vs intrusive) in 84 natural interactions between 17 primary care physicians and 84 patients with common somatic symptoms. Data were analyzed using a mixed-effects logistic regression model, with role, gender, and consultation phase as predictors. RESULTS: Of the 2,405 interruptions observed, 82.9% were cooperative. Among physicians, men were more likely to make an intrusive interruption than women (ß = 0.43; SE, 0.21; odds ratio [OR] = 1.54; 95% CI, 1.03-2.31), whereas among patients, men were less likely to make an intrusive interruption than women (ß = -0.35; SE, 0.17; OR = 0.70; 95% CI, 0.50-0.98). Patients' interruptions were more likely to be intrusive than physicians' interruptions in the phase of problem presentation (ß = 0.71; SE, 0.23; OR = 2.03; 95% CI, 1.30-3.20), but not in the phase of diagnosis and/or treatment plan discussion (ß = -0.17; SE, 0.15; OR = 0.85; 95% CI, 0.63-1.15). CONCLUSIONS: Most interruptions in clinical interaction are cooperative and may enhance the interaction. The nature of physicians' and patients' interruptions is the result of an interplay between role, gender, and consultation phase.

Gender stereotyping in medical interaction: A Membership Categorization Analysis.

OBJECTIVE: Gender can be a valuable resource in communication but also a problem, perpetuating gender stereotypes. So far, there has been little attention for how healthcare professionals and patients make gender relevant in medical interactions. The approach of Membership Categorization Analysis (MCA) is particularly pertinent to meticulously analyze gender in medical communication. Applying MCA, this study analyzes how activity descriptions implicitly associated with gender stereotypes, e.g., "carrying a laundry basket up the stairs", feature in the course of GPs' explanations of a question or diagnosis. The aim is to provide a new perspective on the relationship between gender and medical interaction, and to increase our understanding of how gender stereotypes are reproduced in the medical setting. METHOD: Two cases of GPs using gendered explanations in Dutch general practice interactions are analyzed turn-by-turn using MCA. RESULTS: The findings show how GPs' descriptions of gendered activities serve the exemplification of technical terms, designed for the specific patient, while also casting the patient in a traditional gender role. CONCLUSION: Invoking gender in medical interaction may serve a communicative goal while also perpetuating stereotypes. PRACTICE IMPLICATIONS: Insight in the subtleties of gender construction in medical interactions could enhance gender awareness and sensitivity in healthcare.