One cultural dimension within the sociocultural approach is Power Distance Index (PDI). Cultures with a higher PDI indicate that a hierarchy between less powerful and more powerful individuals is firmly established in society and rarely questioned. In those cultures where a low PDI has been established, more people within society question authority and believe that authority figures are not particularly superior to themselves. One study that researched the effects of Power Distance Index on culture was carried out by Meeuwesen et al (2009), which investigated how cross-national differences in medical communication can be understood from PDI. The study researched 307 GP's and 5,807 appointments from 10 different European countries. All sessions were videotaped and analysed. Results from the study showed that cultures with a higher PDI were associated with shorter consultation sessions and less unexpected information exchange. The interactions were mostly one-sided with the doctor speaking and the patient listening. In cultures with a lower power distance index, doctors shared more information with the patient, they were more open to questions, with the sessions being longer and more flexible. Using this study as an example shows how there are differences across cultures, implying that hierarchical systems have an effect on individual behaviour under what one perceives as an authority situation.