PATTERNS OF NONVERBAL INTERACTION
BETWEEN FAMILY PHYSICIANS AND
THEIR PATIENTS IN MONTREAL
This study, undcrtakcn at Montreal General Hospital
during the summcr and early fall of 1985, rcprcscnts the first
phase of a larger project investigating the nonverbal patterns of
communication used by family practice physicians to establish
and maintain rapport with their middle-aged and elderly paticnts.
Nonverbal patterns of communication consist,
principally, of proxemics, the cultural use of space for interaction
and communication; kinesics, body set, bodily motion, and
pumhnguuge, extra-linguistic noises often
associated with the expression of attitude and mood. Rapport as
uscd in this study refers to the fcclings of trust, confidence,
respect, and solidarity shared by a doctor with a patient. The
premise of this study is that nonverbal patterns of behavior, bccause they are largely outside the awareness of the participants,
can provide an excellcnt indicator of rapport between a doctor
and a patient.
There have bcen several studies of doctor-patient interaction.1 They all begin with the finding that therapeutic procedures, especially those involving patient compliance (i.e.,
taking recommended medication), dcpcnd strongly on the physician's ability to establish rapport with the patient. Many studies
have uscd the Bales interaction process analysis model for
evaluating rapport between a doctor and paticnt.
Frecman et al, using a modified version of thc Bales model,
found that successful results were achieved by doctors who made
many positive statcmcnts, displayed warmth and solidarity, used
tension releasers like jokes, and cngagcd their patients in nonmedical conversations.
On thc other hand, doctors who
appeared to be cold, hostile, or antagonistic received ncgativc
cvaluation from their pa ticnts.
The primary tool used in evaluating doctor-paticnt