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01.12.2012 | Annotated bibliography | Ausgabe 1/2012 Open Access

International Journal for Equity in Health 1/2012

The social gradient in doctor-patient communication

International Journal for Equity in Health > Ausgabe 1/2012
Evelyn Verlinde, Nele De Laender, Stéphanie De Maesschalck, Myriam Deveugele, Sara Willems
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1475-9276-11-12) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions and acknowledgements

VE, NdeL, WS and MdeS equally contributed to the research and the report of the study, DM helped formulating the core idea and was involved in the final editing of the manuscript. All authors read and approved the final manuscript



In recent years, the importance of social differences in the physician-patient relationship has frequently been the subject of research. A 2002 review synthesised the evidence on this topic. Considering the increasing importance of social inequalities in health care, an actualization of this review seemed appropriate.


A systematic search of literature published between 1965 and 2011 on the social gradient in doctor-patient communication. In this review social class was determined by patient's income, education or occupation.


Twenty original research papers and meta-analyses were included. Social differences in doctor-patient communication were described according to the following classification: verbal behaviour including instrumental and affective behaviour, non-verbal behaviour and patient-centred behaviour.


This review indicates that the literature on the social gradient in doctor-patient communication that was published in the last decade, addresses new issues and themes. Firstly, most of the found studies emphasize the importance of the reciprocity of communication.
Secondly, there seems to be a growing interest in patient's perception of doctor-patient communication.

Practice implications

By increasing the doctors' awareness of the communicative differences and by empowering patients to express concerns and preferences, a more effective communication could be established.
Authors’ original file for figure 1
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