Cross-cultural aspects of physician-patient communications patterns

This article reports findings of a study which utilized audiotapes to examine interaction patterns between ten white Anglo physicians (three of whom spoke Spanish) and 61 Hispanic and non-Hispanic patients. Using a newly developed interaction analysis instrument, the study examined four scales-rapport, patient health beliefs, therapeutic regimen, and patient feedback-and two additional categories-quality of explanation of medical regimen and sensitivity to patient modesty. Findings in the analysis of patient-doctor interactions were compared to variables of patient understanding and physician perception of the interview. Patient charts were also examined to determine diagnosis, prescribed medical regimen, and follow-through on return appointments. In analyzing the patient-doctor interactions, the interview raters perceived physicians as performing significantly better on the dimensions of rapport, quality of medical regimen explanation, and ability to elicit patient feedback with the non-Hispanic and English-language patients than with the Hispanic and Spanish-speaking patients. Also, the interaction of factors of language, translator and ethnicity appeared to have a highly significant influence on whether the medication prescriptions were understood by the patient. There were no significant differences related to ethnicity in terms of patient understanding of their diagnosis, or of the cause of their health condition, or in terms of their return for follow-up appointments.