Greater Patient Satisfaction in Same-Race Doctor-Patient Relationships

A recent study from the Johns Hopkins Bloomberg School of Public Health found that patients who are of the same race as their doctor report more satisfaction with their physician. When given the opportunity to choose their own physician, patients were also more likely to pick doctors of the same race. In addition, white respondents were more likely to be race-concordant with their physician when compared to African-American, Hispanic, and Asian American respondents. “Is Doctor-Patient Race Concordance Associated with Greater Satisfaction with Care?” was published in the September 2002 issue of the Journal of Health and Social Behavior.

Thomas A LaVeist, PhD, a study co-author and associate professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health, said, “Although the theory that patients prefer a doctor of their own race is quite popular, that hypothesis had never been thoroughly tested. We wanted to determine if it was indeed true that patients express greater satisfaction if they have a physician of the same race group.”

Previous studies have found that patients who are satisfied with their physicians were more likely to keep follow-up appointments and comply with a prescribed medical regimen and less likely to initiate a malpractice suit in the event of an adverse medical outcome.

The study was conducted using the 1994 Commonwealth Fund Minority Health Survey, a nationally representative sample of adults 18 years of age and older residing in households with telephones within the 48 contiguous United States. Researchers examined a sample of African-American, white, Hispanic, and Asian-American respondents.

With the exception of Asian Americans, the study respondents were most likely to have a white physician. Asian Americans were more likely to be race-concordant. In addition, African-American and Hispanic respondents were more likely than whites to have physicians from minority groups other than their own. Persons who had a choice in the selection of their physician and those for whom English is a secondary language (Hispanic and Asian-American respondents) were significantly more likely to have a doctor of their same race.

The data examined by researchers do not allow for a fuller exploration of why patients choose to be race concordant with their physician. However, researchers suggest three hypotheses to explain the pattern; the first being that patients are more likely to trust and feel greater comfort with physicians of the same race group because of an intrinsic sense of connection, whether it is deserved or undeserved. The second hypothesis is that patients have negative opinions of physicians not in their race group, which may be from lingering distrust between races. And finally, researchers question if patients may be reacting to past experiences or the experiences of others where physicians not of their same race were less courteous or less engaging; or conversely patients may be reacting to positive experiences with physicians of their same race group.

“It has been projected that minority populations in the United Sates will be, by the mid-century, a majority of the population and the demand for minority physicians will likely increase. However, other studies have shown that at the current rates of production, the supply of minority physicians will fall short of future demand,” said Dr. LaVeist.

Johns Hopkins Bloomberg School of Public Health researchers suggest that the avoidance of these shortcomings can be achieved by increasing the number of minority physicians, while placing greater emphasis on improving the ability of physicians to interact with patients who are racially, ethnically, or otherwise culturally different than they are.

Amani Nuru-Jeter, doctoral candidate in the School’s Department of Health Policy and Management, co-authored the study.

The study was supported by a grant from the Commonwealth Fund.

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