The Relationship of Patient Ethnicity/Race to Physician-Patient Communication: A Mixed-Methods Systematic Review

Some scholars have suggested that social and cultural barriers between physicians and patients might contribute to health disparities. The purpose of this review was to determine the state of evidence regarding how physician communication patterns differ by patient ethnicity. Seventy-nine studies employing a range of methodologies were identified. Results were mixed, with about three-quarters of analyses finding no differences in physician communication by ethnicity, and a small number of analyses finding that Black and Hispanic patients experienced better physician communication than White patients. About one-fifth of analyses reported that Black, Hispanic, Asian/Pacific Islander, and American Indian/Alaska Native patients had poorer experiences of physician communication than White patients. This was the case both for studies that operationalized patient-provider communication as behavior (what physicians did, measured via content analysis), and those that operationalized it as judgment (how patients interpreted that behavior, measured via survey or focus group interview). Methodological limitations in the corpus of the literature make it difficult to determine which contexts and characteristics lead patients from minoritized groups to have better, equivalent, or worse experiences than White patients.