Abstract
ObjectiveThe paper characterizes outpatient communication in a major cancer hospital in southern China with regard to the structure, style and focus of doctor–patient communication.MethodFifty‐one encounters between doctors and patients were recorded in the outpatient department of the cancer hospital and analysed inductively to identify patterns of doctor–patient outpatient communication.ResultsOutpatient communication in the cancer hospital is characterized by structuralized conversation, doctor domination of the conversation and a focus on technology during communication. These characteristics suggest an extreme inequality of power between Chinese doctors and patients at the individual level. They are also shaped by the institutional environment of Chinese hospitals.DiscussionMeasures should be taken at both the interpersonal and institutional level to improve doctor–patient communication. At the micro‐interpersonal level, public education and professional skills training are needed to improve communication and promote mutual understanding between patients and doctors. At the macro‐institutional level, changes are needed in terms of transforming the structural factors that shape doctor–patient communication.ConclusionsStructuralized conversation, doctor domination of the conversation and a focus on technology during outpatient encounters present challenges to effective doctor–patient communication. These patterns are shaped by the institutional environment of Chinese hospitals and suggest the extreme power imbalance between Chinese doctors and patients.
Highlights
Chinese patients have become increasingly dissatisfied with health professionals, as reflected by rising conflict and dissension.[1-4]
According to a national survey, more than 70% of the medical respondents stated that inadequate communication with patients contributes to poor doctor–patient relationships.[7]
Chinese doctors, like doctors in many western contexts,[20,38,39] play the dominant role; yet, Chinese patients have far less negotiating power in outpatient clinics compared to their peers in western societies.[3,40]
Summary
Chinese patients have become increasingly dissatisfied with health professionals, as reflected by rising conflict and dissension.[1-4]. Communication difficulty between doctors and patients is linked to the underlying differences in knowledge, culture, professional training, power and status that exist between doctors and patients.[17,18] It indicates a “clash of perspectives” between doctors who are treating diseases in clinics and patients who are coping with illness in their daily lives,[19] as well as the mismatch between “the voice of medicine” and “the voice of the life‐world.”[20] Yet, to what extent does Chinese doctor–patient communication differ from or remain similar to that in the western context? This research analyses Chinese doctor–patient communication in an outpatient department of a cancer hospital. This research analyses doctor–patient communication in an outpatient department of a cancer hospital It outlines the characteristics of Chinese outpatient communication, reveals the individual and institutional factors that contribute to poor communication and, in the process, considers measures for improvement
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