Black patients seek less information from doctors

African Americans are less likely than whites to question their doctors or raise concerns about their care, which may contribute to the racial disparities seen in U.S. healthcare, researchers reported Monday.

In a study of 137 patients with known or suspected lung cancer, investigators found that black patients were less likely than their white counterparts to prod their doctors for more information during consultations.

The findings do not discount the possibility that some doctors give black patients less information due to racial bias, perhaps believing that African Americans are less likely to understand or follow medical advice.

But they do suggest that black patients are less active in their own care, which may contribute to the racial disparities studies have found in patient outcomes, the study authors report in the journal Cancer.

Many studies have found that black Americans are less likely than whites to receive certain medical treatments and tend to fare more poorly after being diagnosed with any number of diseases, including various types of cancer.

For the current study, researchers led by Dr. Howard S. Gordon of the Michael E. DeBakey VA Medical Center in Houston wanted to find out whether white and black patients received different information from their doctors during visits.

After recording discussions between doctors and 137 patients with definite or possible lung cancer, the researchers counted the number of times the doctor made "information-giving statements" about the patient's condition, treatment options and other matters. They also recorded the number of times each patient asked a question, expressed worries or voiced an opinion.

In all, Gordon's team found, African Americans received less information, but not because doctors volunteered less. Instead, the difference was that white patients tended to push for more information.

There are a number of possible explanations for the racial disparity, according to Gordon and his colleagues. One is that black patients have less trust in their doctors; in an earlier study, the researchers found that African Americans did lack such trust - partly because they thought their doctors were poor communicators.

Whatever the reason, the researchers conclude, the findings point to a need to help all patients communicate with their doctors. Pamphlets or other tools that guide patients in the types of questions to ask might help, Gordon's team notes.

They add that patients should also bring a family member or friend to the consultation so they have someone else who can raise questions or concerns.

SOURCE: Cancer, September 15, 2006.