Doctor–patient communication in Southeast Asia: a different culture?

• Published in: Advances in health sciences education : theory and practice Vol. 18; no. 1; pp. 15 - 31
• Main Authors: Claramita, Mora, Nugraheni, Mubarika D. F., van Dalen, Jan, van der Vleuten, Cees
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.03.2013; Springer; Springer Nature B.V
• Subjects: Asian Culture; Attitude of Health Personnel; Clinics; Coding; Communication; Context Effect; Cultural Characteristics; Education; Female; Foreign Countries; Grounded Theory; Humans; Individual Characteristics; Indonesia; Internal Medicine; Interpersonal Communication; Interpersonal Relationship; Interviews; Male; Medical Education; Paternalism; Patient Satisfaction; Physician Patient Relationship; Physician-Patient Relations; Physicians; Qualitative Research; Social Distance; Southeast Asia; Asia; Indonesia; Doctor–patient communication; Southeast Asian culture; Intercultural communication
• ISSN: 1382-4996; 1573-1677
• DOI: 10.1007/s10459-012-9352-5

Studies of doctor–patient communication generally advocate a partnership communication style. However, in Southeast Asian settings, we often see a more one-way style with little input from the patient. We investigated factors underlying the use of a one-way consultation style by doctors in a Southeast Asian setting. We conducted a qualitative study based on principles of grounded theory. Twenty residents and specialists and 20 patients of a low or high educational level were interviewed in internal medicine outpatient clinics of an Indonesian teaching hospital and two affiliated hospitals. During 26 weeks we engaged in an iterative interview and coding process to identify emergent factors. Patients were generally dissatisfied with doctors’ communication style. The doctors indicated that they did not deliberately use a one-way style. Communication style appeared to be associated with characteristics of Southeast Asian culture, the health care setting and medical education. Doctor–patient communication appeared to be affected by cultural characteristics which fell into two broad categories representing key features of Southeast Asian culture, “social distance” and “closeness of relationships”, and to characteristics categorized as “specific clinical context”. Consideration of these characteristics could be helpful in promoting the use of a partnership communication style.