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Disparities/Minority Health

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Black patients tend to ask fewer questions of their doctors and receive less information than other patients

Good doctor-patient communication is critical to making appropriate medical decisions. A new study suggests that less participation by black patients in medical discussions with their doctors—rather than race per se—may be why they receive less information from their doctors than white patients. Communication may be more difficult for black patients than for white patients for a number of reasons. For example, blacks may have different views of health and illness and may be less trustful of the medical profession. Communication issues are likely to be most prominent in interactions between patients and doctors who are different races, note the study authors.

Researchers found that black patients with suspicious or cancerous lung masses were less likely to bring a companion to physician consultations. Black patients and their companions received significantly less information during consultations with doctors than white patients (49.3 vs. 87.3 mean utterances) and made significantly fewer contributions to the discussion (21.4 vs. 37.2 comments or questions). Yet, after adjusting for patients' and companions' participation, clustering by doctor, and other factors, race no longer predicted how much information the doctor provided.

Similarly, information provided by doctors in response to comments or questions by patients was significantly less frequent among visits with patients of a different race than the same race as the doctor. However, after controlling for patients' participation and other factors, racial discordance between patient and physician did not predict the amount of information given by the doctor. The findings were based on analysis of audiotapes of 137 patients receiving initial treatment recommendations in thoracic surgery or oncology clinics at a large Veterans Affairs Medical Center from 2001 to 2004. The study was supported in part by the Agency for Healthcare Research and Quality (HS10876).

More details are in "Racial differences in doctors' information-giving and patients' participation," by Howard S. Gordon, M.D., Richard L. Street Jr., Ph.D., Barbara F. Sharf, Ph.D., and Julianne Souchek, Ph.D., in the September 15, 2006, Cancer 107(6), pp. 1313-1320.


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