Racial disparities in treatment for lung cancer are well documented. Different races might prefer different types of treatment, but studies show that this is not substantial enough to account for the magnitude of racial disparities in health care. In light of this research, the communication between doctors and their patients have become a new focus.

A small study published in the Sept. 15 issue of Cancer suggests that African Americans are less likely to ask questions during one-time office visits, therefore, they receive significantly less information from their doctors than their Caucasian counterparts. When doctors and patients were of the same race, however, this disparity disappeared.

At two clinics in a Houston Veterans Affairs Medical Center, researchers made audio recordings of one-time office visits made by 137 patients between 2001 and 2004. Participants were mostly male patients with lung cancer or nodules (or growths) in their lung; 30 were African American and the rest were Caucasian. Age, gender, marital and health status were similar by race throughout the study. After analyzing the audio data for doctors’ information-giving and patients' (or their companions') active participation (classified as “utterances”) researchers found that African Americans were significantly less likely to receive information from their Caucasian doctors than Caucasian patients.

Doctors provided the same amount of information when they initiated information-giving, but African Americans were less likely than Caucasians to initiate a discussion in which they raised concerns or asked questions, and they did usually went alone to the appointments.

What it means: This study might not apply to women, as there were few female participants. Also, the study looked at a single office visit and did not consider that communication between African American patients and their doctors might improve over time. But even with its limits, this small study raises important issues about doctor-patient communication. Race aside, doctors provide more information to patients who are actively engaged in the office visit or consultation. Heath practitioners might help their patients by focusing even more on aligning goals, communication styles and perceptions to optimize doctor-patient interactions—particularly if each is of a different race. 

We all get nervous sitting face to face with our doctor in his or her office. But remember: our concern, or someone else’s concern, brought us there. The following tips might make the visit a better one:

Don’t feel shy or intimidated. If we don’t speak up and voice our concerns, we might miss out on important information concerning our health and treatment options.
No question is a dumb question. Doctors often say that they appreciate questions from patients, because it shows them that patients are actively concerned, want to be informed and want the ensuing health care to be a team effort.
Bring a friend. A friend might have a question that you don’t think to ask—or raise an issue that causes the doctor to provide a more elaborate explanation.

From the Archive:

May 29, 2006: Teaching Doctors To Care
May 1, 2006: Q: What Scares Doctors? A: Being the Patient