Nonverbal response patterns in physician-patient interactions: A functional analysis

In this paper, we examined physician-patient interactions in terms of the communicative functions accomplished during these encounters. Specifically, the nonverbal communicative exchanges of 38 physician-patient interactions in a family practice clinic were investigated. Two distinctive communicative patterns characterized these interactions. First, physicians nonverbally exerted greater dominance and control by employing longer speaking turns, more social touch, and more pauses while speaking than did the patients. Secondly, physicians and patients tended to reciprocate nonverbal behaviors signalling affiliation including gaze, response latencies, body orientations, and gestures. Consistent with previous research, there was a strong positive relationship between patients' satisfaction with health care and perceptions of the physicians' affiliativeness. Although there were few significant effects, physicians perceived less affiliative tended to be more vocally and gesturally active relative to the patients' nonverbal behavior styles. Finally, there were positive relationships between patients' perceptions of physicians' dominance and the physicians' use of task touch, and the extent to which physicians produced more interruptions and maintained more indirect body orientations relative to the patients' performances of these behaviors. The results are discussed in terms of the communicative functions of nonverbal behavior in physician-patient interactions and of patients' preferences for physicians' nonverbal expressiveness.The authors wish to thank Joe Cappella, Howard Waitzkin, Martha Davis, and William B. Stiles for their helpful comments on previous drafts of this paper.