Surgical Outcomes ResearchSurgeons' tone of voice: A clue to malpractice history*,☆☆
Section snippets
Overview
The study used 114 conversations recorded during routine medical visits between patients and community-practicing surgeons. Half of the surgeons had previous malpractice claims and half had never experienced a claim. Brief 10-second segments of the tapes were extracted and coded for tone of voice. Logistic regressions were performed to examine the contribution of voice tone, beyond the content of speech, to predicting malpractice claims history.
Physicians
Sixty-five surgeons (orthopedic and general
Surgeon demographics
Of the 57 surgeons, 23 were general surgeons and 34 were orthopedic surgeons. The median number of years since medical school graduation was 15.5, ranging from 12 to 41 years. The mean self-reported number of hours with patients per week was 58, with a range of 18 to 76 hours. More than half the surgeons were in single-specialty groups, a few were in multispecialty groups, and the rest were in solo practice. Except for 2 African-American men and 1 Native-American man, all the surgeons were
Discussion
Ratings of surgeons' tone of voice from very brief segments (four 10-second clips) of audiotaped conversations were associated with the previous malpractice claims of surgeons, after controlling for vocal content. Thus, 40 seconds of surgeons' speech distinguished between claims and no-claims surgeons, revealing the power of the information communicated by the voice. These findings suggest that, in the medical encounter, “how” a message is conveyed may be as important as “what” is said.
References (28)
- et al.
Towards a histology of social behavior: judgmental accuracy from thin slices of behavior
Doctor-patient communication and the quality of care
Soc Sci Med
(1991)- et al.
The effects of doctor-patient communication on satisfaction and outcome of care
Soc Sci Med
(1978) Facing our mistakes
N Engl J Med
(1984)Error in Medicine
JAMA
(1994)- et al.
The doctor patient relationship and malpractice—lessons from plaintiff depositions
Arch Intern Med
(1994) - et al.
Obstetricians' prior malpractice experience and patients' satisfaction with care
JAMA
(1994) - et al.
Physician-patient communication: the relationship with malpractice claims among primary care physicians and surgeons
JAMA
(1997) - et al.
Listening and talking to patients: a remedy for malpractice suits?
West J Med
(1993) Accuracy in social perception: contributions of facial and vocal information
J Pers Soc Psychol
(1991)
A semantic index of vocal pitch
Speech Monogr
The effects of various modes of public reading
J Appl Psych
Nonverbal concomitants of perceived and intended persuasiveness
J Pers Soc Psych
Nonverbal behaviors, persuasion, and credibility
Hum Commun Res
Cited by (312)
ED WAIT: A communication model for addressing difficult patient encounters in the emergency department
2024, American Journal of Emergency MedicineEffect of verbal communication on chronic pain: A systematic review
2024, KinesitherapieCoping With Radiology Malpractice Litigation
2022, Journal of the American College of RadiologyAchieving Mutual Understanding Without Saying a Word: The Conceptualization of Moqi and a Nomological Network
2023, Management and Organization ReviewVirtual reality evidence on the impact of physicians' open versus defensive communication on patients
2023, Health Economics, Policy and Law
- *
Supported by the Agency for Health Care Policy Research, Grant No. RO1 HS07289, the Bayer Institute for Health Communication, and the National Science Foundation Presidential Early Career Award for Scientists and Engineers (SBR 9733706).
- ☆☆
Reprint requests: Nalini Ambady, Department of Psychology, 1420 William James Hall, Harvard University, Cambridge, MA 02138.