56

QUANTITATIVE

STUDIES

OF POWER-CLAIMING

TAL

By involving the other person in the decision to close down a topic, a speake
can avoid cutting off the other speaker before hearing everything that needs to b
said. This is power-sharing behavior. Or, the speaker can claim the power to unilat
erally change topics, and suddenly make the switch. In that case, one speaker make
the decision to close the topic and does so without securing agreement from the other
In this way, the speaker claims power over the content of the conversation.
Gender may be a factor in the ways topics are changed.

Gender and Power in Medical Encounters

In chapter 2, I introduced the role of gender in discourse and the common finding
that women are more likely to be cooperative in discourse, whereas men are more
likely to be competitive. The studies of gender in medical discourse tend to sup
port that finding.
There are indications that male and female physicians claim power to different
extents and in different ways. West suggested that U.S. female physicians were interrupted more often than men (1984c) and were more egalitarian in the way they is
sued directives, or commands (1990). Pizzini (1991) found Italian female physicians
more egalitarian than men in the number of directives they used (if a smaller number of directives from the physician implies a more equal balance of power) and les
likely than male physicians to use humor to stop patients from talking.
Another indicator that physicians' behavior differs with their gender appears
in patients' satisfaction: Both male and female patients evaluated care from female
residents more favorably than care from male residents (Linn, Cope, and Leak
1984). Apparently this is not caused by differences in the residents' modes of treatment; a review of the literature by Arnold et al. (1988) found no reported differences between male and female physicians in actual therapeutic actions taken
Arnold et al. suggest that ways of communicating, discourse behavior, probably
are the source of this difference in patients' satisfaction.
However, the data on gender and medical discourse is not yet extensive. Dis
course studies (and conclusions) have been based on very small numbers of female
physicians. K. Davis's (1988) study of gender and power involved a review of315
tapes with 52 physicians, but all the physicians were men (63% of the patients wer
women). In West's (l984c) well-known study mentioned earlier, 21 medical en
counters were analyzed, but only four encounters involved female physicians. Al
four female physicians were white. Two of the four encounters were with black
women patients, one encounter was with a black man, and one was with a white
man. The ethnic diversity of the patients is a complicating factor in evaluating
West's results; did differences arise from gender, from ethnicity, or from some
combination?
In Pizzini's (1991) study, mentioned earlier, again only four female physicians
were studied. The comparison was between four female gynecologists and four male
gynecologists, in a total of 40 encounters. Pizzini did not say how many encounters took place with each gender of physician, so the scope of her data is unclear.