The Effects of Race and Racial Concordance on Patient-Physician Communication: A Systematic Review of the Literature

Institute of Medicine, Unequal treatment: confronting racial and ethnic disparities in healthcare. 2003: Washington DC.

Kahn KL, et al. Health care for black and poor hospitalized Medicare patients. JAMA. 1994;271(15):1169–74.

Fiscella K, et al. Inequality in quality: addressing socioeconomic, racial, and ethnic disparities in health care. JAMA. 2000;283(19):2579–84.

Fennell ML. Racial disparities in care: looking beyond the clinical encounter. Health Serv Res. 2005;40(6 Pt 1):1713–21.

National Center for Health Statistics. Available from: www.cdc.gov/nchs/fastats/lcod.htm .

Saha S, et al. Patient-physician racial concordance and the perceived quality and use of health care. Arch Intern Med. 1999;159(9):997–1004.

Mayberry RM, Mili F, Ofili E. Racial and ethnic differences in access to medical care. Med Care Res Rev. 2000;57(4 suppl):108–45.

Smedley, B.D., A.Y. Stith, and A.R. Nelson, Unequal treatment: confronting racial and ethnic disparities in health care (full printed version). 2002: National Academies Press.

Laveist TA, Nuru-Jeter A. Is doctor-patient race concordance associated with greater satisfaction with care? J Health Soc Behav. 2002;43(3):296–306.

Cooper LA, et al. Patient-centered communication, ratings of care, and concordance of patient and physician race. Ann Intern Med. 2003;139(11):907–15.

Sweeney CF, et al. Race/ethnicity and health care communication: does patient-provider concordance matter? Med Care. 2016;54(11):1005–9.

Penner LA, et al. Life-threatening disparities: the treatment of black and white cancer patients. J Soc Issues. 2012;68(2):328–57.

Stewart MA. Effective physician-patient communication and health outcomes: a review. CMAJ: Canadian Medical Association Journal. 1995;152(9):1423.

Street Jr RL, Gordon H, Haidet P. Physicians’ communication and perceptions of patients: is it how they look, how they talk, or is it just the doctor? Soc Sci Med. 2007;65(3):586–98.

Ghods BK, et al. Patient-physician communication in the primary care visits of African Americans and whites with depression. J Gen Intern Med. 2008;23(5):600–6.

Alexander J, Hearld L, Mittler JN. Patient-physician role relationships and patient activation: the moderating effects of race and ethnicity. Med Care Res Rev. 2014;71(5):472–95.

Ayanian JZ, et al. Patients’ experiences with care for lung cancer and colorectal cancer: findings from the cancer care outcomes research and surveillance consortium. J Clin Oncol. 2010;28(27):4154–61.

Beach MC, et al. Patient-provider communication differs for black compared to white HIV-infected patients. AIDS Behav. 2011;15(4):805–11.

Leyva, B., et al., Do men receive information required for shared decision making about PSA testing? Results from a national survey. Journal of Cancer Education, 2015.

Gordon HS, et al. Physician-patient communication following invasive procedures: an analysis of post-angiogram consultations. Soc Sci Med. 2005;61(5):1015–25.

Gordon HS, et al. Racial differences in doctors’ information-giving and patients’ participation. Cancer. 2006;107(6):1313–20.

Beach M, et al. Patient-provider communication differs for black compared to white HIV-infected patients. AIDS & Behavior. 2011;15(4):805–11.

Johnson RL, et al. Patient race/ethnicity and quality of patient-physician communication during medical visits. Am J Public Health. 2004;94(12):2084–90.

Street Jr RL, et al. Affective tone in medical encounters and its relationship with treatment adherence in a multiethnic cohort of patients with rheumatoid arthritis. J Clin Rheumatol. 2015;21(4):181–8.

Street RL, Gordon H, Haidet P. Physicians’ communication and perceptions of patients: is it how they look, how they talk, or is it just the doctor? Soc Sci Med. 2007;65(3):586–98.

Eggly, S., et al., A disparity of words: racial differences in oncologist-patient communication about clinical trials. Health Expect, 2013.

Ong LM, et al. Doctor-patient communication: a review of the literature. Soc Sci Med. 1995;40(7):903–18.

Meghani SH, et al. Patient–provider race-concordance: does it matter in improving minority patients’ health outcomes? Ethn Health. 2009;14(1):107–30.

Moher D, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–9.

Hays RD, et al. Psychometric properties of the CAHPS™ 1.0 survey measures. Med Care. 1999;37(3):MS22–31.

Hausmann LR, et al. Orthopedic communication about osteoarthritis treatment: does patient race matter? Arthritis Care Res (Hoboken). 2011;63(5):635–42.

Levinson W, et al. “It’s not what you say … ”: racial disparities in communication between orthopedic surgeons and patients. Med Care. 2008;46(4):410–6.

Martin KD, et al. Physician communication behaviors and trust among black and white patients with hypertension. Med Care. 2013;51(2):151–7.

Oliver MN, et al. Time use in clinical encounters: are African-American patients treated differently? J Natl Med Assoc. 2001;93(10):380–5.

Keller AO, Gangnon R, Witt WP. Favorable ratings of providers’ communication behaviors among U.S. women with depression: a population-based study applying the behavioral model of health services use. Womens Health Issues. 2013;23(5):e309–17.

Malat J. Social distance and patients’ rating of healthcare providers. J Health Soc Behav. 2001;42(4):360–72.

Taira DA, et al. Do patient assessments of primary care differ by patient ethnicity? Health Serv Res. 2001;36(6 Pt 1):1059–71.

Manfredi C, et al. Are racial differences in patient-physician cancer communication and information explained by background, predisposing, and enabling factors? J Health Commun. 2010;15(3):272–92.

Roter D, Larson S. The Roter interaction analysis system (RIAS): utility and flexibility for analysis of medical interactions. Patient Educ Couns. 2002;46(4):243–51.

Stewart AL, et al. Interpersonal processes of care survey: patient-reported measures for diverse groups. Health Serv Res. 2007;42(3 I):1235–56.

Schnittker J, Liang K. The promise and limits of racial/ethnic concordance in physician-patient interaction. J Health Polit Policy Law. 2006;31(4):811–38.

Jerant A, et al. Patient-provider sex and race/ethnicity concordance: a national study of healthcare and outcomes. Med Care. 2011;49(11):1012–20.

Korthuis PT, et al. Impact of patient race on patient experiences of access and communication in HIV care. J Gen Intern Med. 2008;23(12):2046–52.

Sweeney, C.F., et al., Race/ethnicity and health care communication: does patient-provider concordance matter? Med Care, 2016.

Fongwa MN, et al. Reports and ratings of care: black and white Medicare enrollees. J Health Care Poor Underserved. 2008;19(4):1136–47.

Gupta N, Carr NT. Understanding the patient-physician interaction potential for reducing health disparities. J Appl Soc Sci. 2008;2(2):54–65.

Gordon HS, et al. Racial differences in trust and lung cancer patients’ perceptions of physician communication. J Clin Oncol. 2006;24(6):904–9.

Gordon HS, et al. Racial differences in doctors’ information-giving and patients’ participation. Cancer. 2006;107(6):1313–20.

Laws MB, et al. The association of visit length and measures of patient-centered communication in HIV care: a mixed methods study. Patient Educ Couns. 2011;85(3):e183–8.

Eggly S, et al. Variation in question asking during cancer clinical interactions: a potential source of disparities in access to information. Patient Educ Couns. 2011;82(1):63–8.

Stepanikova I, et al. Non-verbal communication between primary care physicians and older patients: how does race matter? J Gen Intern Med. 2012;27(5):576–81.

Basanez T, et al. Ethnic groups’ perception of physicians’ attentiveness: implications for health and obesity. Psychol Health Med. 2013;18(1):37–46.

Seligman HK, et al. Risk factors for reporting poor cultural competency among patients with diabetes in safety net clinics. Med Care. 2012;50(9 SUPPL. 2):S56–61.

Paddison CAM, et al. Experiences of care among Medicare beneficiaries with ESRD: Medicare consumer assessment of healthcare providers and systems (CAHPS) survey results. Am J Kidney Dis. 2013;61(3):440–1.

Zickmund SL, et al. Racial differences in satisfaction with VA health care: a mixed methods pilot study. J Racial Ethn Health Disparities. 2015;2(3):317–29.

Palmer NR, et al. Racial and ethnic disparities in patient-provider communication, quality-of-care ratings, and patient activation among long-term cancer survivors. J Clin Oncol. 2014;32(36):4087–94.

Saha S, Arbelaez JJ, Cooper LA. Patient-physician relationships and racial disparities in the quality of health care. Am J Public Health. 2003;93(10):1713–9.

Street RL, et al. How does communication heal? Pathways linking clinician–patient communication to health outcomes. Patient Educ Counseling. 2009;74(3):295–301.

Street, RL Jr. Communication in medical encounters: an ecological perspective. In: Thompson TL, Alicia M. Dorsey, Katherine I. Miller, Roxanne Parrott, editors. Handbook of health communication. Mahwah, NJ: Lawrence Erlbaum Associates; 2003.

Van Ryn M, Burke J. The effect of patient race and socio-economic status on physicians’ perceptions of patients. Soc Sci Med. 2000;50(6):813–28.

Green AR, et al. Implicit bias among physicians and its prediction of thrombolysis decisions for black and white patients. J Gen Intern Med. 2007;22(9):1231–8.

Bao Y, Fox SA, Escarce JJ. Socioeconomic and racial/ethnic differences in the discussion of cancer screening:“between-” versus “within-” physician difference. Health Serv Res. 2007;42(3):950–70.

Freimuth VS, et al. African Americans’ views on research and the Tuskegee syphilis study. Soc Sci Med. 2001;52(5):797–808.

Dohan D, Schrag D. Using navigators to improve care of underserved patients: current practices and approaches. Cancer. 2005;104(4):848–55.

Paskett ED, Harrop JP, Wells KJ. Patient navigation: an update on the state of the science (review). CA Cancer J Clin. 2011;61(4):237–49.

Street RL, et al. Understanding concordance in patient-physician relationships: personal and ethnic dimensions of shared identity. Ann Fam Med. 2008;6(3):198–205.

Sepucha KR, et al. Consultation planning to help breast cancer patients prepare for medical consultations: effect on communication and satisfaction for patients and physicians. Journal of Clinial Oncology. 2002;20(11):2695–700.

Cegala DJ. Communicating with your doctor: the PACE system. Columbus, OH: Ohio State University; 2000.

Cegala DJ, Post DM. On addressing racial and ethnic health disparities the potential role of patient communication skills interventions. Am Behav Sci. 2006;49(6):853–67.

Smith AK, Davis RB, Krakauer EL. Differences in the quality of the patient-physician relationship among terminally ill African-American and white patients: impact on advance care planning and treatment preferences. J Gen Intern Med. 2007;22(11):1579–82.

Saha S, et al. Patient-physician racial concordance and the perceived quality and use of health care. Arch Intern Med. 1999;159(9):997–1004.