Determinants of physician-patient communication: The role of language, education and ethnicity.

Abstract

The value of patient-centredness, of which effective physician-patient communication is one key element, has been established within medicine. However, research shows social differences in medical communication according to the patient's social background. This study examines the role of the patient's ethnicity, educational background and language proficiency in relation to physician-patient interaction in 31 countries. More than fifty thousand patients were given a standardized questionnaire to gain insights into the professional behaviour of their family physician and their own expectations and actions. While no effect of ethnicity was found, there was a significant effect of patients' language proficiency and educational level. Patients with lower language proficiencies were more likely to experience more negative interactions with their physicians. Second-generation migrants who did not fill in the questionnaire in an official language were more negative about the patient-physician interaction. Patients who had a greater chance of having a positive patient-physician interaction were more likely to be higher educated. Despite the shift towards patient-centred care in medicine, physician-patient communication is still determined by the patient's educational background and language proficiency. GPs should primarily be trained to tailor their communication styles to match patients' backgrounds.