Middle-aged and older Latino American women in the patient-doctor interaction

Latino women's views of and actual experiences in the patient-doctor interaction have been little explored. In focus groups with middle-aged and older Latino women, topics including assertiveness in the medical encounter, experiences in actual medical encounters, and characteristics of the "ideal" doctor were explored. Contrary to conceptualizations in the literature, assertiveness was viewed as a reciprocal process between patient and doctor, rather than the behavior of the patient alone. Assertiveness centered on obtaining answers to patient health questions. Strategies for self-advocacy were indirect, primarily changing doctors when dissatisfied; while strategies for advocating for family members were direct, primarily expressing dissatisfaction directly to medical staff. Undocumented immigrant status was described as limiting self-assertion and medical care access. Age was linked to doctor gender preferences. Middle-aged women preferred female doctors, while older women preferred male doctors. Across groups, women expressed preference for Spanish-speaking doctors, but not for doctors of the same ethnicity. Trustworthiness was identified by participants as the most important doctor characteristic, and learnable behaviors as exemplifying trustworthiness.