Doctoral Dissertations

Date of Award

8-2005

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Psychology

Major Professor

Cheryl Brown Travis

Committee Members

Deborah R. Baldwin, Joanne M. Hall, Suzanne B. Kurth

Abstract

Past research on gender and the medical encounter has tended to focus on gender differences in behavior of both patients and physicians. Less effort has been expended in assessing how gender shapes and structures the experience of the medical encounter. The present study aimed to provide insight into aspects of the medical encounter from the perspectives of women patients themselves and to offer insight into the ways gender emerges and is enacted in the medical encounter.

Seventeen women recruited from a population of undergraduate and graduate students participated in a semi-structured interview involving questions about their experiences with and expectations of their relationships with physicians. Participants were asked questions about their good and bad experiences with physicians, their experiences with decision making, their expectations about what happens during the typical medical encounter, and their preferences for male or female physicians. Analysis of interview transcripts utilized feminist theory, grounded theory, discourse analysis, and script theory perspectives and techniques.

Several themes emerged with respect to aspects of the medical encounter that were significant for the women. Participants indicated that it was very important to be involved in the information-sharing process and appreciated both giving and receiving information. Participants also showed a preference to be actively involved in the decision-making process. Participants indicated that it was necessary in some circumstances to provide information about the social and emotional contexts of their lives. There was a normative script for an office visit, but, notably, some elements were missing in the script, namely, how to ask a physician questions and a how to negotiate disagreement with a physician.

Participants’ accounts provided evidence that many aspects of their encounters were gendered and effectively reproduced traditional gender roles common to society in general. Several of the participants recounted stories of being ignored, dismissed and disempowered during their medical encounters. Some of these participants indicated that they thought they would have been treated more respectfully (i.e., would have been allowed to become involved in information sharing and decision making) had they been male patients. Participants’ responses also revealed that some were reluctant to share emotional and contextual information with their physicians, and some indicated that they were reluctant to do this because of the likelihood of being labeled as overly-emotional females. Participants’ comments also demonstrated a belief that male patients would differ in their preferences as patients. Many of the participants believed that most men would prefer to have briefer medical visits with more succinct verbal interactions. Many participants expressed a preference to see a female physician, citing reasons falling within two categories: women physicians know women patients better, and women physicians are better listeners and more caring and comforting.

This and related research may be helpful in training health professionals, who should be given opportunities to better understand how gender influences their own lives and their work. Perhaps an increased awareness may help healthcare professionals provide more equitable services to male and female patients, patients who may become more satisfied and healthy.

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