Fear of Doctors

Abstract

The Fear of Physician (FOP) Psychological Scale is a concise, self-report instrument developed to quantify the specific level of anxiety, tension, and apprehension an individual experiences during communicative interactions with medical doctors. Originating within the discipline of health communication research, the scale focuses critically on the affective dimension of the patient-physician relationship.

Comprising only five items, the FOP scale provides a rapid assessment mechanism, utilizing a straightforward scoring formula to classify respondents into categories of low, moderate, or high fear. This categorization is instrumental for researchers and clinicians seeking to identify and mitigate potential communicative barriers that could negatively impact patient compliance, adherence to treatment, and overall medical outcomes.

Keywords

Fear of Physician, FOP, Medical Anxiety, Communication Apprehension, Physician-Patient Communication, Healthcare Interaction, Patient Outcomes, Health Communication, Psychological Scale.

Authors

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

Purpose

The primary objective of the FOP scale is to provide a reliable quantification of the anxiety experienced by an individual when communicating specifically in a medical setting. This measurement is critical because elevated levels of this specific fear have been consistently linked, both theoretically and empirically, to a range of detrimental patient behaviors.

These adverse behaviors include the withholding of crucial medical information from the physician, reluctance to seek necessary clarification regarding diagnoses or treatment plans, poor adherence to prescribed medications, and a resultant decrease in overall satisfaction with the received healthcare services. Thus, the FOP scale serves as an essential research and diagnostic tool for correlating communication variables with overall medical success and identifying areas where communication training or anxiety reduction interventions may be necessary.

Construct

The FOP scale is designed to measure a highly contextualized form of situational communication apprehension (CA), specifically restricted to the medical environment. The construct is operationalized as the emotional and physiological discomfort—manifesting as feelings of tenseness, nervousness, or jitteriness—that an individual experiences when anticipating or actively engaging in dialogue with a medical professional.

This measure differs significantly from assessments of generalized trait anxiety. FOP is context-dependent, reflecting a specific avoidance or stress response often triggered by factors inherent in the medical relationship, such as the perceived power differential between patient and doctor, the inherent seriousness of medical issues, or the recollection of negative past healthcare experiences. It successfully captures the immediate, affective state during the patient-physician interaction.

Validity

Initial validation studies for the FOP scale established robust evidence for its Construct Validity. This was achieved by demonstrating anticipated patterns of correlation with established psychological and communication constructs. Specifically, FOP scores showed a significant positive correlation with broader measures of general Communication Apprehension (CA).

Furthermore, the scale demonstrated expected negative correlations with positive communication outcomes, such as the patient’s perceived clarity of instructions and overall satisfaction with their care. The items themselves possess high face validity, as they directly address the emotional and affective states experienced during communication with a physician, ensuring that the instrument is perceived as relevant to the concept it intends to measure.

Reliability

The reliability of the FOP scale is primarily substantiated through strong measures of Internal Consistency. Across the developmental and subsequent replication studies, the scale consistently reports high reliability estimates.

In the original 1998 publication, Cronbach’s alpha values were generally reported to be well above the conventionally accepted threshold of 0.70. This high degree of statistical consistency confirms that the five distinct items cohesively measure a single, underlying psychological construct of physician-related anxiety, thereby ensuring the total derived score is a reliable and stable indicator of the measured fear.

Factor Analysis

Based on rigorous statistical testing, including exploratory and confirmatory factor analysis conducted during its development, the FOP scale is definitively conceptualized and validated as a unidimensional instrument. The structure of the scoring formula, which integrates all five items (with appropriate reversals) into a single composite score, reinforces this interpretation.

These initial factor analytic studies confirm that all items load strongly onto one dominant factor, representing the singular construct of overall fear or anxiety experienced when engaging in dialogue with a physician. This strong factor loading supports the clinical and research practice of utilizing a unified total score for the interpretation of physician-related communication anxiety.

Instrument

Test Type: Self-Report Psychological Scale

Format: Five items utilizing a 4-point Likert Scale response format.

Language Available: English (Original); translations may exist in subsequent cross-cultural research.

Population Group: General population seeking or anticipating medical care.

Age Group: Adolescents and Adults (typically 18+).

Population Details: Applicable to individuals who engage in communicative interactions with medical professionals, regardless of the severity of their medical conditions or specific diagnoses.

Test Methodology: Respondents are instructed to indicate the degree to which they experience specific affective states (tense, calm, jittery, nervous, relaxed) when communicating with their physician. Responses range from 1 (“not at all”) to 4 (“very much so”).

Keywords

Health Communication, Patient Anxiety, Medical Phobia, Communication Barriers, Self-Report Instrument, Physician-Patient Relationship, Affective Measures, Likert Scale.

Authors

Author ORCID Identifier: Information not publicly available in source material.

Affiliation Email addresses: Contact information must be sought through the authors’ institutional affiliations at the time of publication.

Correspondence Address: Correspondence is typically directed to James C. McCroskey or the lead author, Virginia P. Richmond, through their respective institutional departments.

Permissions & Fee and Test Year

The FOP scale was first published in 1998. The instrument is generally considered part of the battery of scales developed by the primary author, James C. McCroskey, and is often available for non-commercial academic research use without explicit fees, provided proper citation is utilized. The official instrument and related scoring information can be accessed online at the developer’s dedicated 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 Doctors

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

The scale consists of five items rated on a 4-point Likert Scale.

• When communicating with my physician, I feel tense.
• When communicating with my physician, I feel calm.
• When communicating with my physician, I feel jittery.
• When communicating with my physician, I feel nervous.
• When communicating with my physician, I feel relaxed.

Response Scale: 1 = not at all; 2 = somewhat; 3 = moderately so; 4 = very much so

Scoring Instructions:

1. Step 1. Add the scores for items 1, 3, and 4.
2. Step 2. Add the scores for items 2 and 5.
3. 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.