Surgeons’ affiliative responses to patients’ troubles-telling in outpatient consultations

Abstract

Empathy is recognized as an important way for medical professionals to demonstrate understanding of patients’ experiences and as such, is arguably a key aspect of patient satisfaction in the provision of healthcare. Existing research has examined affiliation as displays of understanding, compassion or agreement by physicians, enabling the integration of empathy in primary care and complementary health settings. Surgeon-patient interactions have received comparatively less analytic attention, prompting the current research on empathic communication in this context. The current study demonstrates the ways in which surgeons routinely responded to patients’ affective expressions of a trouble or problem in diagnostic consultations, through affiliative and non-affiliative displays. Conversation analysis was used to examine the integration or absence of this form of empathy in 75 surgeon-patient consultations, recorded in a metropolitan public hospital. The findings of this research suggest that patterns of surgeon-patient interaction are similar to those observed in general practice and homeopathy, with minimal and extended sequences identified, containing both affiliative and non-affiliative responses to patients’ troubles-telling. The nature and consequences of these responses are explored with consideration to the broader institutional aims of the consultation. Implications of these observations for patient-interaction are discussed in relation to professional training of empathic communication.