Information Giving in Medical Care

Information giving is a crucial element of medical care. This research project considered two theoretically grounded hypotheses: (1) Doctors may withhold information and maintain uncertainty to preserve power in the doctor-patient relationship, and (2) class-based sociolinguistic differences in language use may create further impediments to information giving. A multivariate research model was operationalized to study these hypotheses and to assess other associations between information giving and the characteristics of doctors, patients, and the clinical situations in which they interact. An analysis of a sample of 336 encounters recorded from several outpatient settings revealed that doctors spent little time informing their patients, overestimated the time they did spend, and underestimated patients' desire for information. Contingency-table analysis showed that information transmittal was associated with (1) doctors' income, social class background, political ideology, and perceptions of patients' informative needs; (2) patients' age, sex, social class, education, and prognosis; and (3) situational characteristics such as the length of acquaintance, numbers of patients seen per day, and the types of patients in the doctors' practices. Multiple regression analysis assessed the relative importance of these variables in explaining the variation in information transmittal. The findings did not clearly confirm a relationship among information withholding, uncertainty, and power but did clarify the importance of class-based sociolinguistic barriers to communication.