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A Study of Physician-Patient Ethnic and Gender Concordance and Quality of Communication

Abstract

The importance of effective physician-patient communication for positive health care outcomes has been established; however, the demographic factors that may be associated with deficient physician-patient communication have lacked attention. The present research involved an analysis of 236 medical interactions and was designed to clarify the link between physician-patient ethnic and gender concordance (i.e., matching) and communication quality. It addressed the overarching research question of whether ethnicity matching and/or gender matching is necessary or beneficial for successful communication. Moreover, to tease apart the dynamics within the full scope of physician-patient communication, analyses for the various pairings of ethnicity matching and/or gender matching were conducted using composite variables derived from third-party ratings of physician behaviors in each of three channels of communication: (a) video-only with no audio, (b) full audio with no video, and (c) content-filtered audio (i.e., content of the dialogue is removed and only voice tone, pitch, tempo, etc. remain). Results from the video-only channel demonstrated that patients who interacted with physicians of a different ethnicity experienced significantly more coldness from physicians than those who saw a physician of their same ethnicity (F(1,215)=8.64, p=.004, r=.20). Furthermore, patients who interacted with physicians of their same ethnicity experienced significantly more withdrawal from their physicians than did patients who saw physicians of a different ethnicity (F(1,216)=4.45, p=.036, r=.14). The full audio channel indicated that patients who interacted with physicians of their same gender experienced significantly more coldness from their physicians than did patients who saw physicians of a different gender (F(1,226)=10.76, p=.001, r=.21). The content-filtered channel showed that coldness experienced by patients from physicians in gender-mismatched dyads was significantly greater in ethnically-matched dyads than in ethnically-mismatched dyads (F(1,218)=4.08, p=.045, r=.14). There are differences in the manner in which physicians communicate with their patients based on their respective ethnic and/or gender matching and the channel of communication observed. Implications of the present results will be addressed.

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