Racial Differences in Health Care Decision-Making Blacks and Hispanics receive less information from doctors about rationale for treatment, new public health study finds

Blacks and Hispanics receive less information from their doctors than non-minorities do regarding the rationale for treatment decision-making, according to a new study by researchers from the Boston University Schools of Public Health and Medicine.

The study, published online in Patient Education and Counseling, examined racial and ethnic differences in Americans’ experiences in receiving information from their physicians about the rationale for treatment recommendations. The study used nationally representative survey responses from about 1,240 adults.

Overall, 93 percent of respondents indicated that their doctors discussed reasons for treatment recommendations, including past patient experiences, scientific research, and costs.

But, “the results indicated racial/ethnic minorities received less information from their doctors regarding the rationale for treatment decision making on some, but not all, of the dimensions assessed,” the researchers wrote.

Researchers said the racial and ethnic disparities in overall communication about treatment decisions disappeared after accounting for the socio-demographic characteristics of respondents, such as income.

“This suggests that the observed racial/ethnic disparities in overall information sharing are explained by socioeconomic factors that often ‘travel’ with race, such as gender, income, and insurance status,” they said.

The authors noted that patients’ perceptions of conversations about treatment decisions might vary according to the context of communication occurring during clinical encounters. Minority patients may be “more aware of the lack of conversations regarding doctors’ own experiences and scientific research, than of discussions of cost and how well a treatment works compared to other less expensive treatments.”

The study’s findings are consistent with prior research that has shown “less information sharing, rapport building, or use of other empathic bonding strategies with racial/ethnic minority patients,” the authors said. The variations in information sharing could have negative effects on patient-centered communication and lead to health disparities, they noted.

“By establishing rapport,” they wrote, “minority patients may perceive physician communication to be more supportive, partnering, and informative, and develop a more trusting relationship needed for effective treatment adherence and outcomes.”

The researchers recommended that physicians should evaluate their own patient-communication patterns and “make efforts to ensure that they share equally with all patients regarding the rationale for treatment recommendations.”

The study was led by Meng-Yun Lin, a PhD candidate in health policy and management at the School of Public Health and a research data analyst at Boston Medical Center, and Nancy R. Kressin, a professor at the School of Medicine and a researcher with the Boston VA Healthcare System.