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Do Dutch doctors communicate differently with immigrant patients than with Dutch patients?

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  • Meeuwesen, Ludwien
  • Harmsen, Johannes A.M.
  • Bernsen, Roos M.D.
  • Bruijnzeels, Marc A.

Abstract

The aim of this study was to gain deeper insight into relational aspects of the medical communication pattern in intercultural consultations at GP practices in the Netherlands. We ask whether there are differences in the verbal interaction of Dutch GPs with immigrant and Dutch patients. Data were drawn from 144 adult patient interviews and video observations of consultations between the patients and 31 Dutch GPs. The patient group consisted of 61 non-Western immigrants (Turkish, Moroccan, Surinamese, Antillean, Cape Verdian) and 83 Dutch participants. Affective and instrumental aspects of verbal communication were assessed using Roter's Interaction Analysis System (RIAS). Patients' cultural background was assessed by ethnicity, language proficiency, level of education, religiosity and cultural views (in terms of being more traditional or more modern). Consultations with the non-Western immigrant patients (especially those from Turkey and Morocco) were well over 2Â min shorter, and the power distance between GPs and these patients was greater when compared to the Dutch patients. Major differences in verbal interaction were observed on the affective behavior dimensions, but not on the instrumental dimensions. Doctors invested more in trying to understand the immigrant patients, while in the case of Dutch patients they showed more involvement and empathy. Dutch patients seemed to be more assertive in the medical conversation. The differences are discussed in terms of patients' ethnic background, cultural views (e.g. practicing a religion) and linguistic barriers. It is concluded that attention to cultural diversity does matter, as this leads to different medical communication patterns. A two-way strategy is recommended for improving medical communication, with implications for both doctor and patient behavior.

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  • Meeuwesen, Ludwien & Harmsen, Johannes A.M. & Bernsen, Roos M.D. & Bruijnzeels, Marc A., 2006. "Do Dutch doctors communicate differently with immigrant patients than with Dutch patients?," Social Science & Medicine, Elsevier, vol. 63(9), pages 2407-2417, November.
    • Handle: RePEc:eee:socmed:v:63:y:2006:i:9:p:2407-2417
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    1. Marta-Beatriz Aller & Josep Maria Colomé & Sina Waibel & Ingrid Vargas & María Luisa Vázquez, 2013. "A First Approach to Differences in Continuity of Care Perceived by Immigrants and Natives in the Catalan Public Healthcare System," IJERPH, MDPI, vol. 10(4), pages 1-15, April.
    2. Meershoek, Agnes & Krumeich, Anja & Vos, Rein, 2011. "The construction of ethnic differences in work incapacity risks: Analysing ordering practices of physicians in the Netherlands," Social Science & Medicine, Elsevier, vol. 72(1), pages 15-22, January.
    3. Hannu Valtonen, 2009. "Patient characteristics and fairness," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 10(2), pages 179-186, May.
    4. Sarah Fredsted Villadsen & Hodan Jama Ims & Anne-Marie Nybo Andersen, 2019. "Universal or Targeted Antenatal Care for Immigrant Women? Mapping and Qualitative Analysis of Practices in Denmark," IJERPH, MDPI, vol. 16(18), pages 1-11, September.
    5. Giuseppe Seghieri & Chiara Seghieri & Laura Policardo & Elisa Gualdani & Paolo Francesconi & Fabio Voller, 2019. "Adherence to diabetes care process indicators in migrants as compared to non-migrants with diabetes: a retrospective cohort study," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(4), pages 595-601, May.
    6. Deumert, Ana, 2010. "'It would be nice if they could give us more language' - Serving South Africa's multilingual patient base," Social Science & Medicine, Elsevier, vol. 71(1), pages 53-61, July.

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