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Tone of voice may affect the likelihood that a surgeon will be sued for malpractice

When things go wrong, a surgeon's tone of voice may influence a patient's decision to sue the surgeon, according to a study supported in part by the Agency for Healthcare Research and Quality (HS07289). After controlling for content of conversations, the researchers found that surgeons whose tone of voice signaled less concern/anxiety and more dominance during routine visits with surgical patients were more likely to have been sued than those whose tone was less dominant and more concerned. Researchers audiotaped 114 conversations during routine medical visits between 57 orthopedic and general surgeons and their patients.

Raters who were blind to surgeons' malpractice claims history evaluated 10-second voice clips with content and 10-second voice clips with just voice tone. The sound bites were taped during the first and last minute of each surgeon's interactions with two different patients. Based on the content-filtered audiotapes, surgeons who were judged to be more dominant and less concerned or anxious in tone were more likely to have been sued than surgeons who were judged to be less dominant and more concerned and anxious.

These findings suggest that how the surgeon conveys a message may be as important as what the surgeon says. Expressions of dominance may communicate a lack of empathy and understanding for the patient, while concern or anxiety in the voice is usually associated with empathy. Dominance coupled with a lack of anxiety in the voice may imply surgeon indifference and lead a patient to launch a malpractice suit when poor outcomes occur, explain the researchers. They suggest that listening to brief audio clips might be a useful way to provide feedback and give surgeons a sense of how they sound during interactions, which may improve care satisfaction and reduce lawsuits.

More details are in "Surgeons' tone of voice: A clue to malpractice history," by Nalini Ambady, Ph.D., Debi LaPlante, M.A., Thai Nguyen, B.A., and others, in the July 2002 Surgery 132, pp. 5-9.

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