Fear of Doctors

Abstract

The Fear of Physician (FOP) scale is a concise, five-item psychological scale developed by Richmond, Smith, Heisel, and McCroskey in 1998. It is specifically designed to measure the level of anxiety and apprehension experienced by individuals during communication encounters with their physician.

The scale operationalizes FOP as a form of situational communication apprehension that negatively impacts patient-provider interactions. High scores on the FOP scale are theorized to correlate with reduced information seeking, decreased adherence to medical advice, and potentially unfavorable perceived medical outcomes.

Keywords

Fear of Physician, FOP, Physician Anxiety, Health Communication, Communication Apprehension, Patient-Provider Interaction, Medical Outcomes, Self-Report.

Authors

Virginia P. Richmond, Rebecca S. Smith, Alan M. Heisel, James C. McCroskey.

Purpose

The primary purpose of the FOP scale is to quantitatively assess the degree of situational anxiety or fear an individual experiences when engaging in dialogue with a medical professional. This instrument serves to isolate this specific fear from broader psychological constructs, allowing researchers to study the unique impact of physician-specific anxiety.

The scale was developed to facilitate research into how this specific fear influences critical health behaviors, including patient satisfaction, the clarity of information exchange, and adherence to prescribed treatments, ultimately linking communication apprehension to perceived medical outcomes in the healthcare setting.

Construct

The FOP scale measures a specific, context-dependent construct: the Fear of Physician. This construct is characterized by immediate affective and physiological responses—such as feeling tense, jittery, or nervous—that arise when an individual anticipates or engages in verbal interaction with a doctor. It is conceptualized as a sub-type of communication apprehension that is triggered solely by the physician-patient relationship.

The items focus exclusively on the emotional state during communication, capturing the intensity of negative feelings (tension, nervousness) and the absence of positive, relaxed feelings. High FOP is understood to function as a significant communication barrier, potentially leading to suboptimal diagnosis and treatment due to patient non-disclosure.

Validity

The FOP scale exhibits strong face validity, as its items directly reflect common emotional states related to anxiety experienced in professional interactions. Initial psychometric analyses confirmed its theoretical relationship with broader measures of communication apprehension, supporting its construct validity.

The scale has demonstrated predictive utility by showing a statistically significant negative relationship between high FOP scores and positively perceived medical outcomes. This suggests the instrument accurately measures a construct relevant to real-world health behaviors and patient satisfaction within the medical system.

Reliability

Despite its brevity, consisting of only five items, the FOP scale has consistently demonstrated acceptable to high levels of internal consistency across various research samples. Reliability is typically reported using Cronbach’s alpha coefficients, which often exceed the standard acceptable threshold of 0.80. This high internal consistency indicates that the five items reliably measure a single, cohesive psychological dimension related to anxiety in the medical context.

Factor Analysis

The FOP scale is designed and validated as a unidimensional measure. Factor analytic studies, including both exploratory and confirmatory methods, generally support a single-factor structure. This confirms that all five items load significantly onto one underlying latent variable that represents the overall magnitude of fear and tension associated with physician interaction, justifying the use of a single, summated score.

Instrument

Test Type: Self-report inventory measuring affective and situational communication anxiety.

Format: Five statements administered using a 4-point Likert scale, where responses range from 1 (not at all) to 4 (very much so). Items 2 and 5 are phrased positively and require reverse scoring.

Language Available: Primarily English (original administration).

Population Group: General adult population seeking medical care.

Age Group: Typically Adolescents and Adults (18 years and older).

Population Details: Applicable to any individual engaging in or anticipating communicative interaction with a healthcare provider, particularly in primary care settings.

Test Methodology: The scale utilizes a transformation formula to yield a total FOP score ranging from 5 to 20. The calculation is FOP = 15 + (Sum of scores for items 1, 3, and 4) – (Sum of scores for items 2 and 5).

Keywords

Physician-Patient Relationship, Health Anxiety, Medical Apprehension, Psychological Assessment, Communication Barrier, Affective Measure, Unidimensional Scale.

Authors

Author ORCID Identifier: Not publicly available or provided in the source material.

Affiliation Email addresses: Contact information for authors (Richmond, Smith, Heisel, McCroskey) must be sought through their respective institutional affiliations, often in the field of Communication Studies.

Correspondence Address: Refer to the original 1998 publication in Communication Research Reports for the corresponding author’s institutional address.

Permissions & Fee and Test Year

The FOP scale was developed and published in 1998. As is common with many instruments created by James C. McCroskey and his colleagues, the scale is frequently made available for non-commercial academic research use without an associated fee, although users are advised to seek formal permission from the primary authors or their estates prior to use. The instrument details and scoring instructions are publicly accessible online via the original source website: http://www.jamescmccroskey.com/measures/fop.htm.

Reference’s

• Richmond, V. P., Smith, R. S., Heisel, A. M., & McCroskey, J. C. (1998). The impact of communication apprehension and fear of talking with a physician and perceived medical outcomes. Communication Research Reports, 15, 344-353.

Items of the Fear of Physician (FOP)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The response scale is: 1 = not at all; 2 = somewhat; 3 = moderately so; 4 = very much so.

1. When communicating with my physician, I feel tense.

2. When communicating with my physician, I feel calm.

3. When communicating with my physician, I feel jittery.

4. When communicating with my physician, I feel nervous.

5. When communicating with my physician, I feel relaxed.

Scoring:

Step 1. Add the scores for items 1, 3, and 4.

Step 2. Add the scores for items 2 and 5 (These are the reverse-scored items).

Step 3. Complete the following formula: FOP = 15 + total for Step 1 – total for Step 2.

Interpretation:

• Scores above 13 indicates high fear of physician.

• Scores below 7 indicate low fear of physician.

• Scores between 7 and 13 indicate moderate fear of physician.