Journal of General Internal Medicine

, Volume 22, Issue 6, pp 882–887 | Cite as

Reducing Racial Bias Among Health Care Providers: Lessons from Social-Cognitive Psychology

  • Diana Burgess
  • Michelle van Ryn
  • John Dovidio
  • Somnath Saha


The paper sets forth a set of evidence-based recommendations for interventions to combat unintentional bias among health care providers, drawing upon theory and research in social cognitive psychology. Our primary aim is to provide a framework that outlines strategies and skills, which can be taught to medical trainees and practicing physicians, to prevent unconscious racial attitudes and stereotypes from negatively influencing the course and outcomes of clinical encounters. These strategies and skills are designed to: l) enhance internal motivation to reduce bias, while avoiding external pressure; 2) increase understanding about the psychological basis of bias; 3) enhance providers’ confidence in their ability to successfully interact with socially dissimilar patients; 4) enhance emotional regulation skills; and 5) improve the ability to build partnerships with patients. We emphasize the need for programs to provide a nonthreatening environment in which to practice new skills and the need to avoid making providers ashamed of having racial, ethnic, or cultural stereotypes. These recommendations are also intended to provide a springboard for research on interventions to reduce unintentional racial bias in health care.


provider behavior disparities race ethnicity social cognition 


  1. 1.
    Moy E, Dayton E, Clancy CM. Compiling the evidence: The national health care disparities reports. Health Aff (Millwood). 2005;24(2):376–87.Google Scholar
  2. 2.
    Smedley BD, Stith AY, Nelson AR, eds. Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare. Washington, D.C.: National Academy Press; 2002.Google Scholar
  3. 3.
    Kelley E, Moy E, Stryer D, Burstin H, Clancy C. The national healthcare quality and disparities reports: an overview. Med Care. 2005;43(suppl 3):I3–8, Mar.PubMedGoogle Scholar
  4. 4.
    van Ryn M, Burke J. The effect of patient race and socio-economic status on physicians’ perceptions of patients. Soc Sci Med. 2000;50(6):813–28.PubMedGoogle Scholar
  5. 5.
    van Ryn M. Research on the provider contribution to race/ethnicity disparities in medical care. Med Care. 2002;40(suppl):I 140–51.PubMedGoogle Scholar
  6. 6.
    Burgess DJ, Fu SS, van Ryn M. Why do providers contribute to disparities and what can be done about it? J Gen Intern Med. 2004;19(11):1154–9.PubMedGoogle Scholar
  7. 7.
    Kelly CE. Bringing homophobia out of the closet: antigay bias within the patient–physician relationship. Pharos Alpha Omega Alpha Honor Med Soc. 1992;55(1):2–8.PubMedGoogle Scholar
  8. 8.
    Kelly JA, St Lawrence JS, Smith S, Hood HV, Cook DJ. Medical students’ attitudes toward AIDS and homosexual patients. J Med Educ. 1987;62(7):549–56.PubMedGoogle Scholar
  9. 9.
    Kelly JA, St Lawrence JS, Smith S, Jr., Hood HV, Cook DJ. Stigmatization of AIDS patients by physicians. Am J Public Health. 1987;77(7):789–91.PubMedGoogle Scholar
  10. 10.
    Lewis G, Croft-Jeffreys C, David A. Are British psychiatrists racist? Br J Psychiatry. 1990;157:410–15.PubMedCrossRefGoogle Scholar
  11. 11.
    Like R, Zyzanski SJ. Patient satisfaction with the clinical encounter: social psychological determinants. Soc Sci Med. 1987;24(4):351–7.PubMedGoogle Scholar
  12. 12.
    Porter JR, Beuf AH. The effect of a racially consonant medical context on adjustment of African-American patients to physical disability. Med Anthropol. 1994;16(1):1–16.PubMedCrossRefGoogle Scholar
  13. 13.
    Rosenthal MP, Diamond JJ, Rabinowitz HK, et al. Influence of income, hours worked, and loan repayment on medical students’ decision to pursue a primary care career. JAMA. 1994;271(12):914–7.PubMedGoogle Scholar
  14. 14.
    Roter DL, Hall JA. Strategies for enhancing patient adherence to medical recommendations. JAMA. 1994;271(1):80.PubMedGoogle Scholar
  15. 15.
    Schulman KA, Berlin JA, Harless W, et al. The effect of race and sex on physicians’ recommendations for cardiac catheterization. N Engl J Med. 1999;340(8):618–26.PubMedGoogle Scholar
  16. 16.
    Stern M, Arenson E. Childhood cancer stereotype: impact on adult perceptions of children. J Pediatr Psychol. 1989;14(4):593–605.PubMedGoogle Scholar
  17. 17.
    Tobin JN, Wasserheil-Smoller S, Wexler JP, et al. Sex bias in considering coronary bypass surgery. Ann Intern Med. 1987;107:19–25.PubMedGoogle Scholar
  18. 18.
    Darley JG. A hypothesis confirming bias in labeling effects. In: Stangor C, ed. Sterotypes and Prejudice. Ann Arbor, MI: Taylor and Francis, Psychology Press; 2000.Google Scholar
  19. 19.
    Duncan B. Differential social perception and attribution. J Pers Soc Psychol. 1976;34:22–37.Google Scholar
  20. 20.
    Kunda Z. Social Cognition: Making Sense of People. Cambridge, MA: M.I.T. Press; 1999.Google Scholar
  21. 21.
    Kunda Z, Sherman-Williams B. Stereotypes and the construal of individuating information. Pers Soc Psychol Bull. 1993;19:90–9.Google Scholar
  22. 22.
    Lepore L, Brown R. Category and stereotype activation: is prejudice inevitable? J Pers Soc Psychol. 1997;72:275–87.Google Scholar
  23. 23.
    Locksley A, Hepburn C, Ortiz V. Social stereotypes and judgements of individuals: an instance of the base-rate fallacy. J Exp Soc Psychol. 1982;18:23–42.Google Scholar
  24. 24.
    Sagar H, Schofield J. Racial and behavioral cues in black and white children’s perceptions of ambiguously aggressive acts. J Pers Soc Psychol. 1980;39:590–8.PubMedGoogle Scholar
  25. 25.
    Stangor C, ed. Stereotypes and prejudice. Key readings in social psychology. Philadelphia: Psychology Press; 2001.Google Scholar
  26. 26.
    Banaji M, Greenwald AG. Implicit stereotyping and prejudice. In: Zanna MP, Olson JM, eds. The Psychology of Prejudice, The Ontario Symposium, vol. 7: 55–76.Google Scholar
  27. 27.
    Devine PG, Monteith MJ. Automaticity and control in stereotyping. In: Chaiken S, Trope Y, eds. Dual-process Theories in Social Psychology. New York: Guilford Press; 1999:339–60Google Scholar
  28. 28.
    Dovidio JF, Gaertner SL. On the nature of contemporary prejudice: The causes, consequences, and challenges of aversive racism. In: Eberhardt JL, Fiske, ST eds. Racism: The problem and the Response. Newbury Park, CA: Sage; 1998.Google Scholar
  29. 29.
    Dovidio JF, Kawakami K, Gaertner SL. Implicit and explicit prejudice and interracial interaction. J Pers Soc Psychol. 2002;82(1):62–8.PubMedGoogle Scholar
  30. 30.
    Fazio RH, Jackson JR, Dunton BC, Williams CJ. Variability in automatic activation as an unobtrusive measure of racial attitudes: a bona fide pipeline? J Pers Soc Psychol. 1995;69(6):1013–27.PubMedGoogle Scholar
  31. 31.
    Wilson TD, Lindsey S, Schooler TY. A model of dual attitudes. Psychol Rev. 2000;107(1):101–26.PubMedGoogle Scholar
  32. 32.
    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(11):907–15.PubMedGoogle Scholar
  33. 33.
    Cooper-Patrick L, Powe NR, Jenckes MW, Gonzales JJ, Levine DM, Ford DE. Identification of patient attitudes and preferences regarding treatment of depression. J Gen Intern Med. 1997;12(7):431–8.PubMedGoogle Scholar
  34. 34.
    Hooper EM, Comstock LM, Goodwin JM, Goodwin JS. Patient characteristics that influence physician behavior. Med Care. 1982;20(6):630–8PubMedGoogle Scholar
  35. 35.
    Johnson RL, Roter D, Powe NR, Cooper LA. Patient race/ethnicity and quality of patient–physician communication during medical visits. Am J Public Health. 2004;94(12):2084–90.PubMedCrossRefGoogle Scholar
  36. 36.
    Cooper LA, Beach MC, Johnson RL, Inui TS. Delving below the surface. Understanding how race and ethnicity influence relationships in health care. J Gen Intern Med. 2006;21(suppl 1):S21–7.PubMedGoogle Scholar
  37. 37.
    Cooper LA, Roter D. Patient–provider communication: the effect of race and ethnicity on process and outcomes of healthcare. In: Smedley BD, Stith AY, Nelson AR, eds. Unequal treatment: confronting racial and ethnic disparities in healthcare. Washington, D.C.: The National Academies Press; 2003:552–93.Google Scholar
  38. 38.
    Schuman H, Steeh C, Bobo L, Krysan M. Racial attitudes in America: Trends and interpretations, 2nd ed. Cambridge, MA: Harvard University Press; 1997.Google Scholar
  39. 39.
    Bobo L. Racial attitudes and relations at the close of the twentieth century. In: Smelser NJ, Wilson WJ, Mitchell F, eds. Racial trends and their consequences. Washington, DC: National Academy Press; 2001:264–301.Google Scholar
  40. 40.
    Wittenbrink B, Judd CM, Park B. Evidence for racial prejudice at the implicit level and its relationship with questionnaire measures. J Pers Soc Psychol. 1997;72(2):262–74.PubMedGoogle Scholar
  41. 41.
    Hunt JS, Rothmann TL, Rothman AJ, Iyer SN, McGorty EK. Implicit and explicit associations between health problems and social groups. Psychol Health. In press.Google Scholar
  42. 42.
    Brewer MB, Brown RJ. Intergroup relations. In: Gilbert DT, Fiske ST, Lindzey G, eds. The Handbook of Social Psychology (4th ed). Boston, MA: McGraw-Hill; 1998.Google Scholar
  43. 43.
    Dovidio JF, Gaertner SL. Aversive racism. In: Zanna MP, ed. Advances in Experimental Social Psychology. Vol 36. San Diego, CA: Academic Press; 2004:1–51.Google Scholar
  44. 44.
    Tajfel H, ed. Differentiation between Social Groups: Studies in the Social Psychology of Intergroup Relations. Oxford, England: Academic Press; 1978.Google Scholar
  45. 45.
    Devine PG, Monteith MJ. The role of discrepancy-associated affect in prejudice reduction. In: Mackie DM, Hamilton DL, eds. Affect, Cognition and Stereotyping: Interactive Processes In Intergroup Perception. Orlando, FL: Academic Press; 1993:317–44.Google Scholar
  46. 46.
    Kawakami K, Dovidio JF, Moll J, Hermsen S, Russin A. Just say no (to stereotyping): effects of training in the negation of stereotypic associations on stereotype activation. J Pers Soc Psychol. 2000;78(5):871–88.PubMedGoogle Scholar
  47. 47.
    Bargh J. The cognitive monster: The case against controllability of automatic stereotype effects. In: Chaiken S, Trope Y, eds. Dual Process Theories in Social Psychology. New York: Guilford Press; 1999:361–82.Google Scholar
  48. 48.
    Brewer MB. A dual process model of impression formation. In: Wyer TSSRS, ed. Advances in Social Cognition. Vol I. Hillsdale, NJ: Erlbaum; 1988:1–36.Google Scholar
  49. 49.
    Fiske ST, Lin M, Neuberg SL. The continuum model: ten years later. In: Trope SCY, ed. Dual Process Theories in Social Psychology. New York: Guilford; 1999:211–54.Google Scholar
  50. 50.
    Blair IV. The malleability of automatic stereotypes and prejudice. Pers Soc Psychol Rev. 2002;6:242–61.Google Scholar
  51. 51.
    Fisher JD, Fisher WA, Amico KR. An information-motivation-behavioral skills model of adherence to antiretroviral therapy. Health Psychol. 2006;25:462–73.PubMedGoogle Scholar
  52. 52.
    Greenwald AG, McGhee DE, Schwartz JLK. Measuring individual differences in implicit cognition: the implicit association test. J Pers Soc Psychol. 1998;74(6):1464–80.PubMedGoogle Scholar
  53. 53.
    Nosek BA. Moderators of the relationship between implicit and explicit evaluation. J Exp Psychol Gen. 2005;134:565–84.PubMedGoogle Scholar
  54. 54.
    Leippe MR, Eistenstadt D. Generalization of dissonance reduction: Decreasing prejudice through induced compliance. J Pers Soc Psychol. 1994;67:395–413.Google Scholar
  55. 55.
    Rokeach M. The Nature of Human Values. New York: Free Press; 1973.Google Scholar
  56. 56.
    Dovidio JF, Kawakami K, Gaertner SL. Reducing contemporary prejudice: combating explicit and implicit bias at the individual and intergroup level. In: Oskamp S, ed. Reducing Prejudice and Discrimination. Hillsdale, NJ: Erlbaum; 2000:137–63.Google Scholar
  57. 57.
    Devine PG, Plant E, Amodio DM, Harmon-Jones E, Vance SL. The regulation of explicit and implicit race bias: the role of motivations to respond without prejudice. J Pers Soc Psychol. 2002;82(5):835–48.PubMedGoogle Scholar
  58. 58.
    Plant EAD, Patricia G. Responses to other-imposed pro-Black pressure: acceptance or backlash? J Exp Soc Psychol. 2001;37:486–501.Google Scholar
  59. 59.
    Betancourt JR, Green AR, Carrillo JE, Ananeh-Firempong O, 2nd. Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public Health Rep. 2003;118(4):293–302.PubMedGoogle Scholar
  60. 60.
    Betancourt JR, Green AR, Carrillo JE, Park ER. Cultural competence and health care disparities: key perspectives and trends. Health Aff (Millwood). 2005;24(2):499–505.Google Scholar
  61. 61.
    Macrae C, Bodenhausen GV, Milne AB, Jetten J. Out of mind but back in sight: stereotypes on the rebound. J Pers Soc Psychol. 1994;67(5):808–17.Google Scholar
  62. 62.
    Macrae CN, Bodenhausen GV, Milne AB. Saying no to unwanted thoughts: self-focus and the regulation of mental life. J Pers Soc Psychol. 1998;74(3):578–89.PubMedGoogle Scholar
  63. 63.
    Wenzlaff RMW, Daniel M. Thought suppression. Annu Rev Psychol. 2000;51:59–91.PubMedGoogle Scholar
  64. 64.
    Wyer NA, Sherman JW, Stroessner SJ. The roles of motivation and ability in controlling the consequences of stereotype suppression. Pers Soc Psychol Bull. 2000;26(1):13–25.Google Scholar
  65. 65.
    Shelton JN, Richeson JA, Salvatore J, Trawalter S. Ironic effects of racial bias during interracial interactions. Psychol Sci. 2005;16:397–402.PubMedGoogle Scholar
  66. 66.
    Richeson JA, Shelton JN. When prejudice does not pay: effects of interracial contact on executive function. Psychol Sci. 2003 14:287–90.PubMedGoogle Scholar
  67. 67.
    Plant E, Devine PG. The antecedents and implications of interracial anxiety. Pers Soc Psychol Bull. 2003;29(6):790–801.PubMedGoogle Scholar
  68. 68.
    Vorauer JD, Kumhyr SM. Is this about you or me? Self- versus other-directed judgments and feelings in response to intergroup interaction. Pers Soc Psychol Bull. 2001;27:706–19.Google Scholar
  69. 69.
    Dovidio JF, Gaertner SE, Kawakami K, Hodson G. Why can’t we just get along? Interpersonal biases and interracial distrust. Cultural Diversity and Ethnic Minority Psychology. 2002;8(2):88–102.PubMedGoogle Scholar
  70. 70.
    Dovidio JF, Hebl M, Richeson J, Shelton JN. Nonverbal communication, race, and intergroup interaction. In: Manusov V, Patterson ML, eds. Handbook of Nonverbal Communication. Thousand Oaks, CA: Sage; 2006.Google Scholar
  71. 71.
    Pettigrew TF, Tropp LR. A meta-analytic test of intergroup contact theory. J Pers Soc Psychol. 2006;90(5):751–83.PubMedGoogle Scholar
  72. 72.
    Stephan WG, Stephan CW. Improving Intergroup Relations. Thousand Oaks, CA: Sage; 2001.Google Scholar
  73. 73.
    Stein T, Frankel RM, Krupat E. Enhancing clinician communication skills in a large healthcare organization: a longitudinal case study. Patient Educ Couns. 2005;58(1):4–12.PubMedGoogle Scholar
  74. 74.
    Johnson KJF, Barbara L. “We All Look the Same to Me”: positive emotions eliminate the own-race bias in face recognition. Psychol Sci. 2005;16:875–81.PubMedGoogle Scholar
  75. 75.
    Dovidio JF, Gaertner SL, Isen AM, Lowrance R. Group representations and intergroup bias: positive affect, similarity, and group size. Pers Soc Psychol Bull. 1995;21(8):856–65.Google Scholar
  76. 76.
    Sexton K, Adgate JL, Church TR, et al. Children’s exposure to environmental tobacco smoke: using diverse exposure metrics to document ethnic/racial differences. Environ Health Perspect. 2004;112(3):392–7.PubMedCrossRefGoogle Scholar
  77. 77.
    Krebs D. Empathy and altruism. J Pers Soc Psychol. 1975;32:1134–46.PubMedGoogle Scholar
  78. 78.
    Arroyo JA. Psychotherapist bias with Hispanics: an analog study. Hisp J Behav Sci. 1996;18(21–8).Google Scholar
  79. 79.
    Batson CD. Altruism and prosocial behavior. In: Gilbert DT, Fiske ST, Lindzey G, eds. The Handbook of Social Psychology, No. 2. New York, NY: McGraw-Hill; 1998:282–316.Google Scholar
  80. 80.
    Dovidio JF, Gaertner SL, Stewart TL, Esses VM,ten Vergert M. From intervention to outcomes: processes in the reduction of bias. In: Stephan WG, Vogt P, eds. Intergroup Relations Programs: Practice, Research, and Theory. New York Teachers College Press; 2004:243–65.Google Scholar
  81. 81.
    Batson CD, Polycarpou MP, Harmon-Jones E, et al. Empathy and attitudes: can feeling for a member of a stigmatized group improve feelings toward the group? J Pers Soc Psychol. 1997;72(1):105–18.PubMedGoogle Scholar
  82. 82.
    Dovidio JF, ten Vergert M, Stewart TL, et al. Perspective and prejudice: antecedents and mediating mechanisms. Pers Soc Psychol Bull. 2004;30(12):1537–49.PubMedGoogle Scholar
  83. 83.
    Finlay KA, Stephan WG. Improving intergroup relations: the effects of empathy on racial attitudes. J Appl Soc Psychol. 2000;30(8):1720–37.Google Scholar
  84. 84.
    Galinsky AD, Moskowitz GB. Perspective-taking: decreasing stereotype expression, stereotype accessibility, and in-group favoritism. J Pers Soc Psychol. 2000;78(4):708–24.PubMedGoogle Scholar
  85. 85.
    Carmel S, Glick SM. Compassionate-empathic physicians: personality traits and socio-organizational factors that enhance or inhibit this behavior pattern. Soc Sci Med. 1996;43(8):1253–61.PubMedGoogle Scholar
  86. 86.
    Batson CD, Kobrynowicz D, Dinnerstein JL, Kampf HC, Wilson AD. In a very different voice: unmasking moral hypocrisy. J Pers Soc Psychol. 1997;72(6):1335–48.PubMedGoogle Scholar
  87. 87.
    Beck RS, Daughtridge R, Sloane PD. Physician–patient communication in the primary care office: a systematic review. J Am Board Fam Pract. 2002;15(1):25–38.PubMedGoogle Scholar
  88. 88.
    Ryan S, Hassell A, Dawes P, Kendall S. Control perceptions in patients with rheumatoid arthritis: the impact of the medical consultation. Rheumatology. 2003;42(1):135–40.PubMedGoogle Scholar
  89. 89.
    Kim SS, Kaplowitz S, Johnston MV. The effects of physician empathy on patient satisfaction and compliance. Eval Health Prof. 2004;27(3):237–51.PubMedGoogle Scholar
  90. 90.
    Zachariae R, Pedersen CG, Jensen AB, et al. Association of perceived physician communication style with patient satisfaction, distress, cancer-related self-efficacy, and perceived cntrol over the disease. Br J Cancer. 2004;88(5):658–65.Google Scholar
  91. 91.
    Bellini LM, Baime M, Shea J. Variation of mood and empathy during internship. JAMA. 2002;287:3143–46.PubMedGoogle Scholar
  92. 92.
    Bellini LM, Shea JA. Mood change and empathy decline persist during three years of internal medicine training. Acad Med. 2005;80(2):164–7.PubMedGoogle Scholar
  93. 93.
    Diseker RA, Michielutte R. An analysis of empathy in medical students before and following clinical experience. J Med Educ. 1981;56(12):1004–10.PubMedGoogle Scholar
  94. 94.
    Hojat M, Mangione S, Nasca TJ, et al. An empirical study of decline in empathy in medical school. Med Educ. 2004;38(9):934–41.PubMedGoogle Scholar
  95. 95.
    Cosgray RE, Davidhizar RE, Grostefon JD, Powell M, Wringer PH. A day in the life of an inpatient: an experiential game to promote empathy for individuals in a psychiatric hospital. Arch Psychiatr Nurs. 1990;4(6):354–9.PubMedGoogle Scholar
  96. 96.
    Henderson P, Johnson MH. Assisting medical students to conduct empathic conversations with patients from a sexual medicine clinic. Sex Transm Infect. 2002;78(4):246–9.PubMedGoogle Scholar
  97. 97.
    Seaberg DC, Godwin SA, Perry SJ. Teaching patient empathy: the ED visit program. Acad Emerg Med. 2000;7(12):1433–6.PubMedGoogle Scholar
  98. 98.
    Gaertner SL, Dovidio JF. Reducing Intergroup Bias: The Common Ingroup Identity Model. Philadelphia, PA, US: Psychology Press. 2000;212.Google Scholar
  99. 99.
    Fiske ST. Stereotyping, Prejudice, and Discrimination. Vol 2., 4th ed. Boston: McGraw-Hill; 1998.Google Scholar
  100. 100.
    Fiske ST. What we know about bias and intergroup conflict, the problem of the century. Curr Dir Psychol Sci. 2002;11(4):123–8.Google Scholar
  101. 101.
    Hewstone M, Rubin M, Willis H. Intergroup bias. Annu Rev Psychol. 2002;53:575–604.PubMedGoogle Scholar
  102. 102.
    Hewstone M. The ‘ultimate attribution error’? A review of the literature on intergroup causal attribution. Eur J Soc Psychol. 1990;20:311–35.Google Scholar
  103. 103.
    Howard JW, Rothbart M. Social categorization and memory for in-group and out-group behavior. J Pers Soc Psychol. 1980;38(2):301–10.Google Scholar
  104. 104.
    Park B, Rothbart M. Perception of out-group homogeneity and levels of social categorization: memory for the subordinate attributes of in-group and out-group members. J Pers Soc Psychol. 1982;42(6):1051–68.Google Scholar
  105. 105.
    Dovidio JF, Gaertner SL, Validzic A, Matoka K, Johnson B, Frazier S. Extending the benefits of recategorization: evaluations, self-disclosure, and helping. J Exp Soc Psychol. 1997;33(4):401–20.PubMedGoogle Scholar
  106. 106.
    Hornstein HA. Cruelty and Kindness: A new Look at Aggression and Altruism. Englewood Cliffs, NJ: Prentice Hall; 1976.Google Scholar
  107. 107.
    Piliavin JAD, JF, Gaertner SL, Clark RD. Emergency Intervention. New York: Academic Press; 1981.Google Scholar
  108. 108.
    Nier JA, Gaertner SL, Dovidio JF, et al. Changing interracial evaluations and behavior: the effects of a common group identity. Group Proces Intergroup Relat. 2001;4:299–316.Google Scholar
  109. 109.
    Stewart M, Brown JB, Weston WW, McWhinney IR, McWilliam CL, Freeman TR. Patient-centered Medicine: Transforming the Clinical Method. Thousand Oaks, CA: Sage; 1995.Google Scholar
  110. 110.
    Kinnersley P, Stott N, Peters TJ, Harvey I. The patient-centredness of consultations and outcome in primary care. Br J Gen Pract. 1999;49:711–6.PubMedGoogle Scholar
  111. 111.
    Little P, et al. Preferences of patients for patient centred approach to consultation in primary care: observational study. Br Med J. 2001;322:468–72.Google Scholar
  112. 112.
    Mead N, Bower P, Hann M. The impact of general practitioners’ patient-centredness on patients’ post-consultation satisfaction and enablement. Soc Sci Med. 2002;55(2):283–99.PubMedGoogle Scholar
  113. 113.
    Roter DL, Stewart M, Putnam SM, Lipkin M, Jr., Stiles W, Inui TS. Communication patterns of primary care physicians. JAMA. 1997;277(4):350–6.PubMedGoogle Scholar
  114. 114.
    Stewart M, Brown JB, Donner A, et al. The impact of patient-centered care on outcomes. J Fam Pract. 2000;49(9):796–804.PubMedGoogle Scholar

Copyright information

© Society of General Internal Medicine 2007

Authors and Affiliations

  • Diana Burgess
    • 1
    • 2
  • Michelle van Ryn
    • 1
    • 3
  • John Dovidio
    • 4
  • Somnath Saha
    • 5
  1. 1.Center for Chronic Disease Outcomes Research (a VA HSR&D Center of Excellence)Veterans Affairs Medical CenterMinneapolisUSA
  2. 2.Department of MedicineUniversity of MinnesotaMinneapolisUSA
  3. 3.Department of Family Medicine and Community HealthUniversity of MinnesotaMinneapolisUSA
  4. 4.Department of PsychologyYale UniversityNew HavenUSA
  5. 5.Section of General Internal Medicine, Portland Veterans Affairs Medical Center and Department of MedicineOregon Health & Science UniversityPortlandUSA

Personalised recommendations