Primary Care Research

The doctor-patient relationship is strengthened when patients see themselves as similar to their physicians

Patients who perceive personal similarity with their physician rate more highly their trust and satisfaction with care and intention to adhere to treatment, finds a new study. However, race isn't the only factor underlying patients' perceptions of similarity with their doctor. This study found that perceived similarity in beliefs and values more than race affected their trust, satisfaction, and willingness to follow a doctor's recommendations. The researchers used audiotapes of medical visits to study the interactions of 214 black, Hispanic, and white patients and 29 primary care physicians from 10 private and public outpatient clinics. They correlated post-visit patient ratings of similarity to the doctor and satisfaction, trust, and intent to adhere to physician recommendations.

Factor analysis of the audiotapes revealed two dimensions of beliefs about similarity: personal (in beliefs and values) and ethnic (in race, community). Black and white patients whose doctors were racially similar to them reported more personal and ethnic similarity (mean of 87.6 and 78.8 on a 100-point scale) to their physicians than did minority patients (mean score 81.4 and 41.2) and white patients (mean score 84.4 and 41.9, respectively) whose doctors were of a different race than them. However, when multiple factors were considered, perceived personal similarity was predicted by the patients' age, education, and physician's patient-centered communication (informative, supportive, and facilitative), not by racial or sexual patient-physician concordance. Perceived personal similarity and physicians' patient-centered communication predicted patients' trust, satisfaction, and intent to adhere to the physician's recommendations.

The study was supported in part by the Agency for Healthcare Research and Quality (HS10876).

More details are in "Understanding concordance in patient-physician relationships: Personal and ethnic dimensions of shared identity," by Richard L. Street, Jr., Ph.D., Kimberly J. O'Malley, Ph.D., Lisa A. Cooper, M.D., M.P.H., and Paul Haidet, M.D., M.P.H., in the May/June 2008 Annals of Family Medicine 6(3), pp. 198-205.

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