25 Sep Physician Communication Needs To Vary By Patient Background

MedicalResearch.com Interview with:
Meng-Yun Lin, MPH PhD candidate
Department of Health Policy & Management
Boston University School of Public Health
Boston MA  02118

Medical Research: What is the background for this study? What are the main findings?

Response: Racial and ethnic disparities in health care are widely documented, however the process by which they occur is not fully understood. One potential mechanism is through the process of treatment decision making, and racial/ethnic variations in that communication process. Thus, the goal of this study was to examine racial/ethnic differences in the types of information communicated by physicians regarding their rationale for recommendations for care, using national data collected from a diverse group of respondents.

We found that Americans’ experiences with information communicated by physicians regarding rationale behind treatment recommendations vary on some dimensions by race and ethnicity. In general, Blacks and Hispanics receive less information from their doctors than non-minorities do regarding the rationale for treatment decision-making. Specially, Blacks’ and Hispanics’ doctors less often cited their own experiences, or scientific research as a reason for treatment recommendations. Our findings suggest differences in key elements of shared decision making are evident in the care of racial/ethnic minorities.

Medical Research: What should clinicians and patients take away from your report?

Response: First, the observed variations in information sharing could have negative effects on patient-centered communication and lead to health disparities. Physician should evaluate the extent to which their communication with patients varies by patient race/ethnicity, and make efforts to ensure that they share equally with all patients regarding the rationale for treatment recommendations. By establishing rapport, minority patients may perceive physician communication to be more supportive, partnering, and informative, and develop a more trusting relationship needed to effective treatment adherence and outcomes.

Secondly, “one size does not fit all”. Americans’ experiences with physician communication related to treatment decision making varies with personal characteristics and group membership. Educational materials and informational campaigns may need tailored messages and messaging strategies for varying patient population groups, and efforts to enhance physicians’ skills in help patients “choose wisely” need to ensure that physicians are equipped and skilled in providing patients of all backgrounds with the information they need to ultimately improve the equity and quality of care for all.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: This study was limited by the age of the data, which was collected in 2009 and could be considered old. In the absence of other national surveys of experiences with treatment decision making in this era of great interest in the topic gives this study value as baseline data about American attitudes, prior to the recent increase in attention to shared decision making. Future studies could conduct another national survey using the same or a similar questionnaire to evaluate changes in patient perceptions after the launch of programs that aim to improve the process of treatment decision making.

Also, as highlighted by Choosing Wisely and other patient education campaigns, concerns for overuse and underuse of care could potentially be ameliorated in clinical settings through better communication or health information shared with patients, especially regarding the appropriateness of treatment recommendations. Further studies should focus on potential factors that may impose difficulties on intervention that aims to modify clinician behavior to achieve patient-centered communication and reduce inappropriate use of care.

Citation:

Meng-Yun Lin, Nancy R. Kressin. Race/ethnicity and Americans’ experiences with treatment decision making. Patient Education and Counseling, 2015; DOI: 10.1016/j.pec.2015.07.017

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Meng-Yun Lin, MPH PhD (2015). Physician Communication Needs To Vary By Patient Background 

Last Updated on September 25, 2015 by Marie Benz MD FAAD