Background. There is widespread consensus that a patient-centered physician communication style is beneficial for the patient as well as for the physician. Typically, patient-centered communication is described as a given set of behaviors to adopt by the physician in order to have better consultation outcomes for the patient. Particularly, dominant physician behavior is not part of patient-centered communication. But, as patients all have different needs and preferences, they do not all benefit from the same physician communication style. Some patients prefer a more dominant doctor. A match between the patient's preference in terms of physician communication and the behavior the physician actually displays seems to be related to positive consultation outcomes, and we claim that this is also the case for physician dominance behavior.
Methods. Based on videotapes of 33 general practitioners in consultation with two of their patients, we measured the physicians' nonverbal dominance behavior presented towards each patient. We also assessed each patient's preference concerning the physician's dominance and calculated to what extent each physician adapted his/her nonverbal behavior to the needs and expectations of the patient. Patients also reported how satisfied they were with the consultation, how much they trusted their physician, and as how competent they perceived the physician. These measures were aggregated to form a consultation outcome measure.
Findings. Results show that the more the physicians adapt their nonverbal dominance behavior to their patients' preferences for a dominant or non-dominant physician interaction style, the more positive the consultation outcomes are.
Discussion. The present study shows that an adaptation to patient preferences for dominance is related to positive outcomes. We thus conclude that in term of physician behaviors there is no one size fits all. Physician training might want to focus more on training accurate interpersonal perception and on teaching a diversity of different behavior repertoires instead of a given set of behaviors.