Relational Control in Physician-Patent Encounters

Abstract

To further exploratory work done by O'Hair (1989) in applying relational communication theory to physician-patient communication, this study analyzed 30 transcripts of conversations between physicians and patients with 5,968 utterances and 5,929 exchanges in four contexts: an AIDS clinic, an institutional or home hospice program, a family practice clinic, and hospital rooms or doctor's offices. Results differed from O'Hair's exploratory study in that the predominant transaction control type across all contexts was neutralized symmetry, rather than complementary. Both physicians and patients tended to concentrate messages into three of the nine relational categories: extension, support, and answer. Physicians asked more questions and changed the topic frequently, particularly when the patients raised emotional issues. Physicians did not answer all questions asked by patients. The findings suggest a tendency toward domineering behavior on the part of the patient and a tendency toward control through questioning and topic change on the part of the physician.