Effects of patients' socioeconomic status and physicians' training and practice on patient-doctor communication

To determine characteristics of patients and doctors that are associated with effective communication, patient-doctor communication was studied in 100 ambulatory patients who underwent echocardiography to evaluate previously undefined cardiac problems. As a marker for effective communication, this report examined how often the patient and doctor agreed about basic aspects of care, including symptoms, test results, therapy, and prognosis. Communication between the patient and physician was less effective when the patient was of lower socioeconomic status, as determined by occupation or insurance coverage. Characteristics of physician's training and practice were not significantly associated with better communication. Physicians were unable to predict when their responses would or would not agree with those of their patients. These findings suggest that there is the risk of less effective communication between patients of lower socioeconomic status and their physicians, and that physicians may be unaware that less effective communication is occurring.