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Non-Verbal Communication Between Primary Care Physicians and Older Patients: How Does Race Matter?

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Abstract

BACKGROUND

Non-verbal communication is an important aspect of the diagnostic and therapeutic process, especially with older patients. It is unknown how non-verbal communication varies with physician and patient race.

OBJECTIVE

To examine the joint influence of physician race and patient race on non-verbal communication displayed by primary care physicians during medical interviews with patients 65 years or older.

DESIGN, SETTING, AND PARTICIPANTS

Video-recordings of visits of 209 patients 65 years old or older to 30 primary care physicians at three clinics located in the Midwest and Southwest.

MAIN MEASURES

Duration of physicians’ open body position, eye contact, smile, and non-task touch, coded using an adaption of the Nonverbal Communication in Doctor–Elderly Patient Transactions form.

KEY RESULTS

African American physicians with African American patients used more open body position, smile, and touch, compared to the average across other dyads (adjusted mean difference for open body position = 16.55, p < 0.001; smile = 2.35, p = 0.048; touch = 1.33, p < 0.001). African American physicians with white patients spent less time in open body position compared to the average across other dyads, but they also used more smile and eye gaze (adjusted mean difference for open body position = 27.25, p < 0.001; smile = 3.16, p = 0.005; eye gaze = 17.05, p < 0.001). There were no differences between white physicians’ behavior toward African American vs. white patients.

CONCLUSION

Race plays a role in physicians’ non-verbal communication with older patients. Its influence is best understood when physician race and patient race are considered jointly.

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Contributors

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Funders

This study was supported by University of South Carolina Research Opportunity Program, “Racial and Ethnic Disparities in Non-Verbal Communication Between Physicians and Elderly Patients: A Pilot Study." ($47,557)

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Authors and Affiliations

  1. Department of Sociology, USC, Columbia, SC, USA

    Irena Stepanikova PhD

  2. Institute for Research in the Social Sciences, Stanford University, Palo Alto, CA, USA

    Irena Stepanikova PhD

  3. Department of Sociology, USC, Columbia, SC, USA

    Qian Zhang MA

  4. Division of Geriatrics Services, Palmetto Richland Hospital, Columbia, SC, USA

    Darryl Wieland PhD

  5. Division of Geriatrics, USC School of Medicine, Columbia, SC, USA

    G. Paul Eleazer MD

  6. Division of Geriatrics, USC School of Medicine, Columbia, SC, USA

    Thomas Stewart PhD

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  1. Irena Stepanikova PhD
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  2. Qian Zhang MA
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Correspondence to Irena Stepanikova PhD.

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Stepanikova, I., Zhang, Q., Wieland, D. et al. Non-Verbal Communication Between Primary Care Physicians and Older Patients: How Does Race Matter?. J GEN INTERN MED 27, 576–581 (2012). https://doi.org/10.1007/s11606-011-1934-z

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  • DOI: https://doi.org/10.1007/s11606-011-1934-z

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