Characteristics and Correlates of Word Use in Physician-Patient Communication

Background: Numerous studies have described and evaluated communication in healthcare contexts, but these studies have focused on broad content and complex units of behavior. Growing evidence reveals the predictive power and importance of precise linguistic characteristics of communication. Purpose: This study aims to document characteristics, predictors, and correlates of word use within specific linguistic categories by physicians and patients during a healthcare visit. Methods: Conversations between patients (n = 145) and their physician (n = 6) were audio recorded, transcribed, and analyzed using Linguistic Inquiry Word Count software. Patients also completed questionnaires prior to and immediately following the visit and (for a subset of patients) at a follow-up visit, which assessed patients’ demographics, how much they liked the physician, and self-reported adherence. Physicians completed a questionnaire following the initial visit that assessed the patient’s health status, the physician’s optimism regarding the upcoming treatment, and satisfaction with the productivity of the visit. Results: Patients and physicians differed in the extent of their word use in key linguistic categories, while also maintaining significant linguistic synchrony. Demographic characteristics and health status predicted variability in patients’ and physicians’ word use, and word use predicted key visit outcomes. Most notably, patients liked their physician more when physicians used fewer negative emotion words and were less adherent when physicians used more singular first-person pronouns. Conclusions: These findings reveal patterns in the way physicians speak to patients who vary in their demographic characteristics and health status and point to potentially fruitful targets for linguistic interventions with both physicians and patients.