Racial and Ethnic Disparities in Perceptions of Physician Style and Trust

TLDR

Racial and ethnic disparities in health‑care access and status are well documented, yet the role of patients’ perceptions of physicians as a potential underlying cause has been insufficiently examined. This study investigates whether a person’s race or ethnicity is linked to lower trust in physicians and seeks to understand the reasons for any observed differences. Using a nationally representative sample of 32,929 adults from the 1996–1997 Community Tracking Survey, the authors measured satisfaction with physician style (listening, explanations, thoroughness) and trust (patient‑centered care, referrals, avoidance of unnecessary tests, and insurance influence). After adjusting for socioeconomic factors, minority participants reported significantly less positive perceptions of physicians on both style and trust scales, especially when lacking continuity of care, indicating that racial and ethnic minorities view their physicians more negatively. Arch Fam Med.

Abstract

While pervasive racial and ethnic inequalities in access to care and health status have been documented, potential underlying causes, such as patients' perceptions of their physicians, have not been explored as thoroughly.To assess whether a person's race or ethnicity is associated with low trust in the physician.Data were obtained from the 1996 through 1997 Community Tracking Survey, a nationally representative sample. Adults who identified a physician as their regular provider and had at least 1 physician visit in the preceding 12 months were included (N = 32,929).Patients' ratings of their satisfaction with the style of their physician and their trust in physicians. The Satisfaction With Physician Style Scale measured respondents' perceptions of their physicians' listening skills, explanations, and thoroughness. The Trust in Physician Scale measured respondents' perceptions that their physicians placed the patients' needs above other considerations, referred the patient when needed, performed unnecessary tests or procedures, and were influenced by insurance rules.After adjustment for socioeconomic and other factors, minority group members reported less positive perceptions of physicians than whites on these 2 conceptually distinct scales. Minority group members who lacked physician continuity on repeat clinic visits reported even less positive perceptions of their physicians on these 2 scales than whites.Patients from racial and ethnic minority groups have less positive perceptions of their physicians on at least 2 important dimensions. The reasons for these differences should be explored and addressed. Arch Fam Med. 2000;9:1156-1163