January 30, 2014
This article was reported by Medical Xpress.
Medical Xpress reported on a study of communication and compliance between patients of different races and ethnicity and healthcare providers. M. Barton Laws, assistant professor of health services policy and practice in the Brown University School of Public Health, and colleagues analyzed recorded office visits between 45 healthcare providers and 404 patients, including 245 black and 59 Hispanic individuals. Researchers used the Generalized Medical Interaction Analysis, which separates the dialogue into speech-based units called "utterances" and classifies each utterance's topic or subject matter.
Results showed that black patients spoke less to providers and their interaction had more provider dominance. Providers asked Hispanics fewer open-ended questions. Also, providers' dialogue was more about adherence with minorities than with white patients, regardless of patient adherence history. Doctors issued more directives to minorities than to whites and did not discuss more problem-solving options than for whites.
Laws noted that the study did not determine why doctors emphasized adherence with minority patients even though the issue did not correlate with patient adherence history. Also, doctors did not spend much time on finding patients' barriers to adherence and trying to provide solutions. The researchers suggested that the emphasis on directive rather than problem solving may reflect how providers relate to all patients rather than race. The researchers concluded that other differences in the visits may be due to the ways in which cultural differences and background can affect communication. Laws suggested future studies could examine whether racial differences in the dialogue could lead to different clinical outcomes.
The full report, "Provider-Patient Communication About Adherence to Anti-retroviral Regimens Differs by Patient Race and Ethnicity," was published online in the journal AIDS and Behavior (2014; doi: 10.1007/s10461-014-0697-z).