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RESEARCH AND PRACTICE |
At the time of the study, all the authors were with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Additionally, Neil R. Powe and Lisa A. Cooper are with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, the Department of Medicine, Johns Hopkins School of Medicine, and the Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University.
Correspondence: Requests for reprints should be sent to Lisa A. Cooper, MD, MPH, Associate Professor of Medicine, Epidemiology and Health Policy and Management, Johns Hopkins University School of Medicine, 2024 E Monument St, Ste 2-500, Baltimore, MD 21205–2223 (e-mail: lisa.cooper{at}jhmi.edu).
Objectives. We examined the association between patient race/ethnicity and patient–physician communication during medical visits.
Methods. We used audiotape and questionnaire data collected in 1998 and 2002 to determine whether the quality of medical-visit communication differs among African American versus White patients. We analyzed data from 458 African American and White patients who visited 61 physicians in the Baltimore, Md–Washington, DC–Northern Virginia metropolitan area. Outcome measures that assessed the communication process, patient-centeredness, and emotional tone (affect) of the medical visit were derived from audiotapes coded by independent raters.
Results. Physicians were 23% more verbally dominant and engaged in 33% less patient-centered communication with African American patients than with White patients. Furthermore, both African American patients and their physicians exhibited lower levels of positive affect than White patients and their physicians did.
Conclusions. Patient–physician communication during medical visits differs among African American versus White patients. Interventions that increase physicians’ patient-centeredness and awareness of affective cues with African Americans patients and that activate African American patients to participate in their health care are important strategies for addressing racial/ethnic disparities in health care.
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