Hostile Sexist Male Patients and Female Doctors: A Challenging Encounter

Abstract

Patient characteristics and attitudes can affect how patients react to the physician's communication style, and this reaction can then influence consultation outcomes. The goal of the present study was to investigate whether the attitude of a sexist male patient affects how he perceives a female physician's nonverbal communication and whether this then results in expecting less positive consultation outcomes. Participants were analog patients who viewed four videotaped male and four videotaped female physicians in a consultation with one of their patients. Physician videos were preselected to represent a range of high and low patient-centered physician nonverbal behavior. Participants filled in questionnaires to assess how patient-centered they perceived the female and male physicians' nonverbal communication to be, and participants indicated how positive they expected the consultation outcomes to be. Moreover, we assessed the participants' sexist attitudes with a questionnaire measuring hostile and benevolent sexism. Students (N = 60) from a French-speaking university in Switzerland were recruited on campus. The main outcome measures were the extent to which analog patients expect the consultation outcomes to be positive (high satisfaction, increased trust in the physician, intention to adhere to treatment recommendations, and perceived physician competence) and the extent to which analog patients perceive physicians as patient-centered (judged from the physicians' nonverbal cues). Male analog patients' hostile sexism was negatively related to perceiving the physicians as patient-centered, and male analog patients' hostile sexism was also negatively related to expected positive consultation outcomes. For male patients viewing female physicians, mediation analysis revealed that perceived physician patient-centeredness mediated the negative relationship between hostile sexism and expected positive consultation outcomes. Male hostile sexist patients perceive a female physician's nonverbal communication as less patient-centered and this negatively affects their expectation of positive outcomes from the consultation.