The authors audiotaped each visit and then rated each tape using a standard process that measured whether the communication was more “patient centered” or “doctor centered.” Compared with doctor-centered communication, patient-centered communication involved more opportunities for the patient to talk and to direct the conversation and greater effort to involve the patient in decision making. Before each visit, patients completed a survey that asked about their age, sex, race, education, and health. After each visit, patients completed a survey that asked them to rate whether the doctor encouraged them to participate in decision making, to rate their overall satisfaction, and to say whether they would recommend the doctor to a friend. The researchers then compared communication and satisfaction in 2 groups. The first group included visits in which both the doctor and patient were African American or both were white (race concordant). The second group included visits in which the patient was African American and the doctor was white or vice versa (race discordant).