Patient compliance and satisfaction with physician influence attempts: A reinforcement expectancy approach to compliance-gaining over time.

Communication expectancy and reinforcement principles are systematically integrated to explain the effectiveness of communication strategies focused on improving initial and long-term medical adherence and patient satisfaction. Study 1 analyzed patients' evaluations of communication regard strategies and the effectiveness of these strategies in initial encounters. It was predicted that physician gender would play a major role in patients' communication evaluations. As predicted, negative regard influence strategies used by male physicians were perceived as more appropriate than negative regard influence strategies used by female physicians. Results did not indicate gender differences in perceptions of expectancies or relational concern as communicated by regard strategies. Study 1 also addressed the effectiveness of influence attempts in initial encounters with a physician. The study supports the predicted interaction for communication effectiveness in initial encounters. Specifically, the results support the claim that female physicians are limited to the use of positive regard strategies whereas male physicians are more effective persuaders using either positive or negative regard strategies. The results also indicate that the use of negative regard strategies by male physicians does not hinder patient satisfaction or physician perceptions, whereas the use of negative regard strategies by female physicians is negatively related to these outcome measures. The reinforcement expectancy framework tested in Study 2 argued that occasional use of nonrewarding communication would facilitate communication effectiveness for both male and female physician in ongoing physician-patient relationships. The results supported this assumption. Physician gender, however, did not mediate the effectiveness of certain strategy combinations as expected. Finally, the investigation found that previous exposure to any type of physician communications style, as opposed to never having seen the physician, facilitated a physician's influence attempts