Lisa A. Cooper, MD, MPH; Debra L. Roter, DrPH; Rachel L. Johnson, BA; Daniel E. Ford, MD, MPH; Donald M. Steinwachs, PhD; Neil R. Powe, MD, MPH, MBA
Presented in part at the 23rd Annual Meeting of the Society of General Internal Medicine, Boston, Massachusetts, 6 May 2000.
Disclaimer: The views presented here are those of the authors and not necessarily those of the Commonwealth Fund, its directors, officers, or staff.
Acknowledgments: The authors thank Eliseo Guallar, MD, DrPH, for advice on revision of the manuscript.
Grant Support: By research grants from the Commonwealth Fund, the Bayer Institute for Health Care Communication, and the Robert Wood Johnson Foundation. Dr. Cooper was a fellow in the Robert Wood Johnson Foundation Minority Medical Faculty Development Program during the time this work was conducted.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Lisa A. Cooper, MD, MPH, Welch Center for Prevention, Epidemiology, and Clinical Research, 2024 East Monument Street, Suite 2-500, Baltimore, MD 21205-2223; e-mail, firstname.lastname@example.org.
Current Author Addresses: Dr. Cooper, Ms. Johnson, and Dr. Ford: Welch Center for Prevention, Epidemiology, and Clinical Research, 2024 East Monument Street, Suite 2-500, Baltimore, MD 21205-2223.
Dr. Roter: Johns Hopkins Bloomberg School of Public Health, Hampton House, 624 North Broadway, Room 750, Baltimore, MD 21205-1999.
Dr. Steinwachs: Johns Hopkins Bloomberg School of Public Health, Hampton House, 624 North Broadway, Room 482, Baltimore, MD 21205-1999.
Dr. Powe: Welch Center for Prevention, Epidemiology, and Clinical Research, 2024 East Monument Street, Suite 2-600, Baltimore, MD 21205-2223.
Author Contributions: Conception and design: L.A. Cooper, D.L. Roter, D.E. Ford, N.R. Powe.
Analysis and interpretation of the data: L.A. Cooper, D.L. Roter, R.L. Johnson, D.E. Ford, N.R. Powe.
Drafting of the article: L.A. Cooper, D.L. Roter, R.L. Johnson, N.R. Powe.
Critical revision of the article for important intellectual content: L.A. Cooper, D.L. Roter, R.L. Johnson, D.M. Steinwachs, N.R. Powe.
Final approval of the article: L.A. Cooper, D.E. Ford, N.R. Powe.
Statistical expertise: L.A. Cooper, N.R. Powe.
Obtaining of funding: L.A. Cooper.
Administrative, technical, or logistic support: L.A. Cooper, N.R. Powe.
Cooper LA, Roter DL, Johnson RL, Ford DE, Steinwachs DM, Powe NR. Patient-Centered Communication, Ratings of Care, and Concordance of Patient and Physician Race. Ann Intern Med. 2003;139:907-915. doi: 10.7326/0003-4819-139-11-200312020-00009
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Published: Ann Intern Med. 2003;139(11):907-915.
Compelling evidence demonstrates racial, ethnic, and social disparities in health care in the United States (1-11). African Americans and other ethnic minority patients in race-discordant relationships with their physicians (for example, an African-American patient who visits a white physician) report less involvement in medical decisions, less partnership with physicians, lower levels of trust in physicians, and lower levels of satisfaction with care (12-15). A recent report from the Institute of Medicine on racial and ethnic disparities in health care suggests that various aspects of the patient–physician relationship may contribute to the wide disparities seen in U.S. health care (16). Despite emerging evidence linking interpersonal aspects of care, such as patient–physician communication, to continuity of care and health outcomes (17-22), most studies of disparity have focused on technical aspects of health care, such as receipt of certain tests, procedures, and therapies.
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