Physicians’ Perceptions of Patients’ Social and Behavioral Characteristics and Race Disparities in Treatment Recommendations for Men With Coronary Artery Disease

Ryn, Michelle van; Burgess, Diana J.; Malat, Jennifer; Griffin, Joan M.

doi:10.2105/ajph.2004.041806

Cited by 221 publications

(159 citation statements)

References 70 publications

Supporting

Mentioning

149

Contrasting

Unclassified

Order By: Relevance

“…This finding is consistent with a growing body of evidence indicating that how a physician perceives a patient (likeable, intelligent, adherent) is related to how that doctor treats the patient (Amir, 1987;Beach, Roter, Wang, Duggan & Cooper, 2006a;Gerbert, 1984;Hall et al, 1993;Hall et al, 2002;Van Ryn et al, 2006). However, to assume a causal pathway from perception to communication would be premature.…”

Section: Discussionsupporting

confidence: 84%

“…Second, variability in physicians' communication and perceptions may be related to the patients' demographic characteristics. Even the most well-meaning and egalitarian physicians may have stereotypes or biases based on a patient's demographic status (Burgess, Fu & Van Ryn, 2004;Van Ryn, Burgess, Malat & Griffin, 2006). Racial bias, in particular, has been implicated in research showing that some physicians associate more negative attributes (e.g., non-compliant, less intelligent, more likely to abuse drugs and alcohol) to minority and less educated patients (Van Ryn & Burke, 2000), perceptions that in turn may affect physicians' informativeness (Amir, 1987) and medical decision-making (Krupat, Irish, Kasten, Freund, Burns, Moskowitz et al 1999;Schulman, Berlin, Harless, Kerner, Sistrunk, Gersh et al 1999).…”

Section: Conceptual Framework: An Ecological Approachmentioning

confidence: 99%

See 1 more Smart Citation

Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor?

Street

Gordon

Haidet

2007

Social Science & Medicine

442

359

View full text Add to dashboard Cite

Although physicians' communication style and perceptions affect outcomes, few studies have examined how these perceptions relate to the way physicians communicate with patients. Moreover, while any number of factors may affect the communication process, few studies have analyzed these effects collectively in order to identify the most powerful influences on physician communication and perceptions. Adopting an ecological approach, this investigation examined: (a) the relationships of physicians' patient-centered communication (informative, supportive, partnership-building) and affect (positive, contentious) on their perceptions of the patient, and (b) the degree to which communication and perceptions were affected by the physicians' characteristics, patients' demographic characteristics, physician-patient concordance, and the patient's communication. Physicians (N = 29) and patients (N = 207) from 10 outpatient settings in the United States participated in the study. From audio-recordings of these visits, coders rated the physicians' communication and affect as well as the patients' participation and affect. Doctors were more patientcentered with patients they perceived as better communicators, more satisfied, and more likely to adhere. Physicians displayed more patient-centered communication and more favorably perceived patients who expressed positive affect, were more involved, and who were less contentious. Physicians were more contentious with black patients, whom they also perceived as less effective communicators and less satisfied. Finally, physicians who reported a patient-centered orientation to the doctor-patient relationship also were more patient-centered in their communication. The results suggest that reciprocity and mutual influence have a strong effect on these interactions in that more positive (or negative) communication from one participant leads to similar responses from the other. Physicians' encounters with black patients revealed communicative difficulties that may lower quality of care for these patients.

show abstract

Section: Discussionsupporting

confidence: 84%

Section: Conceptual Framework: An Ecological Approachmentioning

confidence: 99%

Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor?

Street

Gordon

Haidet

2007

Social Science & Medicine

442

359

View full text Add to dashboard Cite

show abstract

“…While studies have suggested that provider recommendations for a variety of medical or surgical procedures vary by patient race/ethnicity, it is unclear to what degree these variations are based on clinical rather than nonclinical factors, including racial stereotypes. 26,[40][41][42][43] In our prior qualitative study, AA and white women who underwent sterilization reported that their provider did not, in fact, influence their decision making about sterilization. 9 In summary, in this nationally representative sample of women of reproductive age, we found that higher rates of unintended and unwanted pregnancies may help explain why minority women are more likely to undergo tubal sterilization compared to white women.…”

Section: Discussionmentioning

confidence: 95%

Unintended Pregnancy Influences Racial Disparity in Tubal Sterilization Rates

Borrero

Moore

et al. 2009

J GEN INTERN MED

View full text Add to dashboard Cite

BACKGROUND: Minority women are more likely than white women to choose tubal sterilization as a contraceptive method. Disparities in rates of unintended pregnancy may help explain observed racial/ethnic differences in sterilization, but this association has not been investigated. OBJECTIVE:To examine the associations among race/ ethnicity, unintended pregnancy, and tubal sterilization. DESIGN AND PARTICIPANTS:Cross-sectional analysis of data from a nationally representative sample of women aged 15-44 years [65.7% white, 14.8% Hispanic, and 13.9% African American (AA)] who participated in the 2002 National Survey of Family Growth. MAIN MEASURES:Race/ethnicity, history of unintended pregnancy, and tubal sterilization. A logistic regression model was used to estimate the effect of race/ ethnicity on unintended pregnancy while adjusting for socio-demographic variables. A series of logistic regression models was then used to examine the role of unintended pregnancy as a confounder for the relationship between race/ethnicity and sterilization.KEY RESULTS: Overall, 40% of white, 48% of Hispanic, and 59% of AA women reported a history of unintended pregnancy. After adjusting for socio-demographic variables, AA women were more likely (OR: 2.0; 95% CI: 1.6-2.4) and Hispanic women as likely (OR: 1.0; 95% CI: 0.80-1.2) as white women to report unintended pregnancy. Sterilization was reported by 29% of women who had ever had an unintended pregnancy compared to 7% of women who reported never having an unintended pregnancy. In unadjusted analysis, AA and Hispanic women had significantly higher odds of undergoing sterilization (OR: 1.5; 95% CI: 1.3-1.9 and OR: 1.4; 95% CI: 1.2-1.7, respectively). After adjusting for unintended pregnancy, this relationship was attenuated and no longer significant (OR: 1.2; 95% CI: 0.95-1.4for AA women and OR: 1.3; 95% CI: 1.0-1.6 for Hispanic women).CONCLUSION: Minority women, who more frequently experience unintended pregnancy, may choose tubal sterilization in response to prior experiences with an unintended pregnancy.KEY WORDS: unintended pregnancy; minority women; tubal sterilization.

show abstract

“…9,10 These studies have typically presented physicians with clinical vignettes 11,12 or used observational databases and adjusted for confounding factors. 13 Far fewer studies have focused on discrimination on the basis of patient socioeconomic status. 8,14 Audit studies, a well-established method of testing for discrimination in labour and housing markets, [15][16][17] have been used in the United States to show that Medicaid recipients and patients who are uninsured encounter substantial barriers to care.…”

Section: Discussionmentioning

confidence: 99%