Studies of doctor-patient interaction.

Judith A. HallDepartment of Psychology, Northeastern University, Boston, Massachusetts 02115INTRODUCTIONDiscussion between doctors and patients has long been regarded as the vehicleby which much of the curing and caring of medicine is conveyed. Sometimesregarded as the art or heart of medicine, its importance was well noted inantiquity and is recognized in modem times. However, it is only since themid-1960s that the actual dynamics of the therapeutic dialogue have beenobserved in any systematic manner and that an attempt to recast this aspect ofmedicine as science has been made. The evolution of methodological andtechnological sophistication has made observation and analysis of the medicalvisit easier over the years, and, indeed, the number of empirical studies ofdoctor-patient communication doubled between 1982 and 1987 to over 60(47).Several reviews of this body of work have been undertaken (28, 39, 51,55,57), but a resulting synthesis has been lacking; this is a difficult body of workto review. The predominantly exploratory nature of this research, which islargely of the kind in which everything gets correlated with everything else(24), contributes to an overwhelming number of results with which to con-tend. The results appear so confusing that Inui & Carter (28), in reviewingthis literature, characterized the findings as a "Rorschach test" for readers inwhich overall interpretations are as apt to reveal something about the reader asabout the results themselves.We have elected, therefore, to supplement a selective review of the litera-l630163 -7525/89/0510-0163502.00www.annualreviews.org/aronline Annual Reviews