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Chiropractic Research Review

Providing Better Care to Our Patients

Race and ethnicity have been cited as important cultural barriers affecting patient-physician communication. Communication problems can contribute to a disparity in the understanding that patients and physicians have of the cause of disease and the effectiveness of available treatments, hampering case management and outcomes.



A telephone survey of 1,816 adults (average age: 41 years) evaluated the influence of race/ethnicity and gender on the patient-physician relationship, and on patients' expectations and sense of participation in the clinical experience. Specifically, patients (66% female, 45% African American, 43% Caucasian) rated their physicians' participatory decision-making (PDM) style on a 100-point scale. (Of the physicians in the study, 37% were female, 25% African-American, 15% Asian, 2% Latino and 56% Caucasian.)

Results of the study are presented as follows:

* African-American patients rated their visits as far less participatory than Caucasian patients.

* Patients who were the same race as their physician rated their visits as significantly more participatory than other patients.

* Patients of female physicians rated their visits as more participatory than patients of male physicians.

* Gender concordance (i.e., male patient/male physician, female patient/female physician) did not have a significant effect upon patient ratings of the visit.

* Patients 40-65 years old rated their experience as more participatory than patients younger than 30 years old.

The authors believe the data underscore the need for improved cross-cultural communication between primary care physicians and patients, noting that such steps in health care settings "...may lead to more patient involvement in care, adherence to recommended treatment, higher quality of care, and better health outcomes."

Cooper-Patrick L, Gallo JJ, Gonzales JJ, et al. Race, gender and partnership in the patient-physician relationship. Journal of the American Medical Association, August 11, 1999:282(6), pp583-89.

Chiropractic Research Review

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