Ethnicity and communication in physician -patient encounters

This study investigated the matching of physicians' and patients' ethnicities as well as patients' minority status as they relate to communication styles in physician-patient interactions. Audiotaped interactions involving 241 patients and 93 physicians were taken from a data set obtained from the Bayer Institute's larger study on the effectiveness of physician and patient training to improve communication. Interactions for the current study involved only those from baseline and control group conditions. It was hypothesized that physicians would be rated more positively when participating in ethnically matched vs. mismatched interactions. In addition, physicians were expected to be rated more positively when interacting with non-minority vs. minority patients, particularly if the physician belonged to a non-minority ethnicity. Ethnicities included were Asian, Euro-American, and Hispanic, and interactions included all combinations (excluding Hispanic physicians with Asian patients, as none were available). Three independent female judges rated each interaction on 53 physician variables using a 9-point Likert scale. Five physician scales were created using factor analysis: Overall Positive Behavior, Positive Psychosocial Skills, Negativity, Relaxed Demeanor, and Professionalism. The results demonstrated that Asian physicians were rated higher on the Professionalism Scale when interacting with Asian patients compared with Euro-American and Hispanic patients. These results were not replicated with non-Asian physicians. Although there were no other significant findings, several findings were potentially consequential. Specifically, there was a trend for minority patients to receive more positive psychosocial care than non-minority patients from all physicians regardless of the physicians' ethnicity. In addition, in contrast with minority physicians, non-minority physicians were found to be more relaxed with and show more professionalism to minority patients. This suggests that the physicians may have been making efforts to put minority patients at ease and to reduce the power differentiation often experienced by this patient population. Future studies will assess these patients' ratings of satisfaction with their physicians to evaluate the degree to which they agree with those of the independent judges. Continued physician training in cultural sensitivity and patient training in improving communication may be effective in increasing patient satisfaction, and thus patient adherence and improved health outcomes for at-risk populations.