Doctors in a Southeast Asian country communicate sub-optimally regardless of patients' educational background

Objective: To explore the relationship between the style of doctor-patient communication and patients' educational background in a Southeast Asian teaching hospital setting using the Roter Interaction Analysis System (RIAS). Methods: We analyzed a total of 245 audio-taped consultations involving 30 internal medicine residents with 7-10 patients each in the internal medicine outpatient clinics. The patients were categorized into a group with a high and a group with a low educational level. We ranked the data into 41 RIAS utterances and RIAS-based composite categories in order of observed frequency during consultations. Results: The residents invariantly used a paternalistic style irrespective of patients' educational background. The RIAS utterances and the composite categories show no significant relationship between communication style and patients' educational level. Conclusion: Doctors in a Southeast Asian country use a paternalistic communication style during consultations, regardless of patients' educational background. Practice implication: To approach a more partnership doctor-patient communication, culture and clinical environment concern of Southeast Asian should be further investigated.