The impact of patient-physician racial and gender concordance on patient satisfaction with outpatient clinic visits
Open accessAbstract
Background Patient and provider race and gender concordance (patient and physician identify as the same race/ethnicity or gender) may impact patient experience and satisfaction. Objective We sought to examine how patient and physician racial and gender concordance effect patient satisfaction with outpatient clinical encounters. Furthermore, we examined factors that changed satisfaction among concordant and discordant dyads. Design Consumer Assessment of Healthcare Provider and Systems (CAHPS) Patient Satisfaction Survey Scores were collected from outpatient clinical encounters between January 2017 and January 2019 at the University of California, San Francisco. Participants Patients who were seen in the eligible time period, who voluntarily provided physician satisfaction scores. Providers with fewer than 30 reviews and encounters with missing data were excluded. Main measures Primary outcome was rate of top satisfaction score. The provider score (1-10 scale) was dichotomized as "top score (9-10)" and "low scores (<9)." Key results A total of 77,543 evaluations met inclusion criteria. Most patients identified as White (73.5%) and female (55.4%) with a median age of 60 (IQR 45, 70). Compared to White patients, Asian patients were less likely to give a top score even when controlling for racial concordance (OR: 0.67; CI 0.63-0.714). Telehealth was associated with increased odds of a top score relative to in-person visits (OR 1.25; CI 1.07-1.48). The odds of a top score decreased by 11% in racially discordant dyads. Conclusions Racial concordance, particularly among older, White, male patients, is a nonmodifiable predictor of patient satisfaction. Physicians of color are at a disadvantage, as they receive lower patient satisfaction scores, even in race concordant pairs, with Asian physicians seeing Asian patients receiving the lowest scores. Patient satisfaction data is likely an inappropriate means of determining physician incentives as such may perpetuate racial and gender disadvantages.
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An increase in diverse population representation among health care professionals is crucial to promote patient-physician relationships with high satisfaction.
“Although an increase in diverse population representation among health care professionals is crucial to promote patient-physician relationships with high satisfaction,5”
From Perceived Success After Participation in the Summer Health Professions Education Program (2024) · cites this paper as [5]
The Conclusion reports that racial concordance is a strong predictor of patient satisfaction, which supports a link between physician diversity and satisfaction in some patient–physician relationships. But the paper does not establish that increasing workforce diversity is crucial to improving satisfaction; it also reports that physicians of color can receive lower scores even in racially concordant pairs. (LLM, conf=0.86)
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Telehealth and patient satisfaction: a systematic review and narrative analysis
Kruse, C. S., Krowski, N., Rodriguez, B., Tran, L., Vela, J., & Brooks, M. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-016242 · Cited by 1,350 · see citing works
Takeshita, J., Wang, S., Loren, A. W., Mitra, N., Shults, J., Shin, D. B., & Sawinski, D. L. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.24583 · Cited by 697 · cited 1× · see citing works
“In light of the conflicting data on race, gender, and patient satisfaction, Takeshita et al. (2020) in a large cross sectional study with a diverse patient and provider population demonstrated that racial concordance between physician and patient is associated with higher satisfaction scores [3].”
Patient Satisfaction With Telemedicine During the COVID-19 Pandemic: Retrospective Cohort Study
Ramaswamy, A., Yu, M., Drangsholt, S., Ng, E., Culligan, P. J., Schlegel, P. N., & Hu, J. C. (2020) · Journal of Medical Internet Research · doi:10.2196/20786 · Cited by 475 · see citing works
Flagged first, then by citations
Research works printed but not linked: 35
- Olaisen RH, Schluchter MD, Flocke SA, Smyth KA, Korouk- ian SM, Stange KC. Assessing the longitudinal impact of phy- sician-patient relationship on functional health. Ann Fam Med. 2020;18(5):422-9. https:// doi. org/ 10. 1370/ AFM. 2554. · DOI
- Martinez KA, Keenan K, Rastogi R, et al. The association between physician race/ethnicity and patient satisfaction: an exploration in direct to consumer telemedicine. J Gen Intern Med. 2020;35(9):2600-6. https:// doi. org/ 10. 1007/ S11606-020-06005-8. · DOI
- Jackson JL, Chamberlin J, Kroenke K. Predictors of patient sat- isfaction. Soc Sci Med. 2001;52(4):609-20. https:// doi. org/ 10. 1016/ S0277-9536(00) 00164-7. · DOI
- Cooper-Patrick L, Gallo JJ, Gonzales JJ, et al. Race, gender, and partnership in the patient-physician relationship. JAMA. 1999;282(6):583-9. https:// doi. org/ 10. 1001/ JAMA. 282.6. 583. · DOI
- Murphy GP, Awad MA, Tresh A, et al. Association of patient vol- ume with online ratings of California urologists. JAMA Surg. 2018;153(7):685-6. https:// doi. org/ 10. 1001/ JAMAS URG. 2018. 0149. · DOI
- Murphy GP, Radadia KD, Breyer BN. Online physician reviews: is there a place for them? Risk Manag Healthc Policy. 2019;12:85-9. https:// doi. org/ 10. 2147/ RMHP. S1703 81. · DOI
- Murphy GP, Awad MA, Osterberg EC, et al. Web-based phy- sician ratings for California physicians on probation. J Med Internet Res. 2017;19(8). https:// doi. org/ 10. 2196/ JMIR. 7488. · DOI
- Petrullo KA, Lamar S, Nwankwo-Otti O, Alexander-Mills K, Viola D. The patient satisfaction survey: what does it mean to your bottom line? J Hosp Adm. 2013;2(2). https:// doi. org/ 10. 5430/ jha. v2n2p1. · DOI
- Siegrist RB. Patient satisfaction: history, myths, and mispercep- tions. Virtual Mentor. 2013;15(11):982-7. https:// doi. org/ 10. 1001/ VIRTU ALMEN TOR. 2013. 15. 11. MHST1-1311. · DOI
- Saha S, Komaromy M, Koepsell TD, Bindman AB. Patient- physician racial concordance and the perceived quality and use of health care. Arch Intern Med. 1999;159(9):997-1004. https:// doi. org/ 10. 1001/ ARCHI NTE. 159.9. 997. · DOI · Paper page
- Haviland MG, Morales LS, Reise SP, Hays RD. Do health care ratings differ by race or ethnicity? Jt Comm J Qual Saf. 2003;29(3):134-45. https:// doi. org/ 10. 1016/ s1549-3741(03) 29016-x. · DOI
- Murray-García JL, Selby JV, Schmittdiel J, Grumbach K, Quesenberry CPJ. Racial and ethnic differences in a patient survey: patients' values, ratings, and reports regarding physi- cian primary care performance in a large health maintenance organization. Med Care. 2000;38(3):300-10. https:// doi. org/ 10. 1097/ 00005 650-20000 3000-00007. · DOI
- Kumar D, Schlundt DG, Wallston KA. Patient-physician race concordance and its relationship to perceived health outcomes. Ethn Dis. 2009;19(3):345-51.
- LaVeist TA, Nuru-Jeter A, Jones KE. The association of doctor-patient race concordance with health services utilization. J Public Health Pol- icy. 2003;24(3-4):312-23. https:// doi. org/ 10. 2307/ 33433 78. · DOI
- Laveist TA, Nuru-Jeter A. Is doctor-patient race concordance associated with greater satisfaction with care? J Health Soc Behav. 2002;43(3):296-306.
- Wallis CJD, Jerath A, Coburn N, et al. Association of surgeon- patient sex concordance with postoperative outcomes. JAMA Surg. 2021. https:// doi. org/ 10. 1001/ JAMAS URG. 2021. 6339. · DOI
- Meghani SH, Brooks JM, Gipson-Jones T, Waite R, Whitfield-Har- ris L, Deatrick JA. Patient-provider race-concordance: does it mat- ter in improving minority patients' health outcomes? Ethn Health. 2009;14(1):107-30. https:// doi. org/ 10. 1080/ 13557 85080 22270 31. · DOI
- Rogo-Gupta LJ, Haunschild C, Altamirano J, Maldonado YA, Fassiotto M. Physician gender is associated with Press Ganey patient satisfaction scores in outpatient gynecology. Women's Heal issues Off Publ Jacobs Inst Women's Heal. 2018;28(3):281-5. https:// doi. org/ 10. 1016/j. whi. 2018. 01. 001. · DOI · Paper page
- Woods SE, Heidari Z. The influence of gender on patient satisfac- tion. J gender-specific Med JGSM Off J Partnersh Women's Heal Columbia. 2003;6(4):30-5.
- Okunrintemi V, Valero-Elizondo J, Patrick B, et al. Gender differences in patient-reported outcomes among adults with atherosclerotic cardiovascular disease. J Am Heart Assoc. 2018;7(24):e010498. https:// doi. org/ 10. 1161/ JAHA. 118. 010498. · DOI · Paper page
- Alsaif A, Alqahtani S, Alanazi F, Alrashed F, Almutairi A. Patient satisfaction and experience with anesthesia: a multicenter survey in Saudi population. Saudi J Anaesth. 2018;12(2):304-10. https:// doi. org/ 10. 4103/ sja. SJA_ 656_ 17. · DOI
- Patel I, Chang J, Srivastava J, Feldman S, Levender M, Balkrishnan R. Patient satisfaction with obstetricians and gynecol- ogists compared with other specialties: analysis of US self- reported survey data. Patient Relat Outcome Meas. 2011;2:21-6. https:// doi. org/ 10. 2147/ PROM. S15747. · DOI
- Mueller BR, Lawrence S, Benn E, et al. Disparities in telehealth utilization in patients with pain during COVID-19. Pain Reports. 2022;7(3):E1001. https:// doi. org/ 10. 1097/ PR9. 00000 00000 001001. · DOI
- Campos-Castillo C, Anthony D. Racial and ethnic differences in self-reported telehealth use during the COVID-19 pandemic: a secondary analysis of a US survey of internet users from late March. J Am Med Inform Assoc. 2021;28(1):119. https:// doi. org/ 10. 1093/ JAMIA/ OCAA2 21. · DOI
- Brown SH, Griffith ML, Kripalani S, Horst SN. Association of health literacy and area deprivation with initiation and completion of telehealth visits in adult medicine clinics across a large health care system. JAMA Netw Open. 2022;5(7):e2223571-1. https:// doi. org/ 10. 1001/ JAMAN ETWOR KOPEN. 2022. 23571. · DOI
- Chang ES, Simon M, Dong XQ. Integrating cultural humility into health care professional education and training. Adv Health Sci Educ Theory Pract. 2012;17(2):269-78. https:// doi. org/ 10. 1007/ S10459-010-9264-1. · DOI
- Tang C, Tian B, Zhang X, et al. The influence of cultural compe- tence of nurses on patient satisfaction and the mediating effect of patient trust. J Adv Nurs. 2019;75(4):749-59. https:// doi. org/ 10. 1111/ JAN. 13854. · DOI
- Davidson KW, Shaffer J, Ye S, et al. Interventions to improve hos- pital patient satisfaction with healthcare providers and systems: A systematic review. BMJ Qual Saf. 2017;26(7):596. https:// doi. org/ 10. 1136/ BMJQS-2015-004758. · DOI
- Argueza BR, Saenz SR, McBride D. From diversity and inclusion to antiracism in medical training institutions. Acad Med. 2021;96(6):798- 801. https:// doi. org/ 10. 1097/ ACM. 00000 00000 004017. · DOI
- Liao L, Chung S, Altamirano J, et al. The association between Asian patient race/ethnicity and lower satisfaction scores. BMC Health Serv Res. 2020;20(1):678. https:// doi. org/ 10. 1186/ s12913-020-05534-6. · DOI
- Butler C, Baskin AS, Mmonu NA, et al. Patient satisfaction in a safety net urology clinic. Urol Pract. 2021;8(2):168-75. https:// doi. org/ 10. 1097/ UPJ. 00000 00000 000177. · DOI
- Saha S, Hickam DH. Explaining low ratings of patient satisfaction among Asian-Americans. Am J Med Qual Off J Am Coll Med Qual. 2003;18(6):256-64. https:// doi. org/ 10. 1177/ 10628 60603 01800 606. · DOI
- Alfred M, Ubogaya K, Chen X, Wint D, Worral PS. Effectiveness of culturally focused interventions in increasing the satisfaction of hospitalized Asian patients: a systematic review. JBI Database Syst Rev Implement Reports. 2016;14(8):219-56. https:// doi. org/ 10. 11124/ JBISR IR-2016-003048. · DOI
- Truong M, Paradies Y, Priest N. Interventions to improve cultural competency in healthcare: a systematic review of reviews. BMC Health Serv Res. 2014;14(1):1-17. https:// doi. org/ 10. 1186/ 1472- 6963-14-99/ TABLES/1. · DOI
- Dunsch F, Evans DK, Macis M, Wang Q. Bias in patient sat- isfaction surveys: a threat to measuring healthcare qual- ity. BMJ Glob Heal. 2018;3(2):694. https:// doi. org/ 10. 1136/ BMJGH-2017-000694. · DOI
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Perceived Success After Participation in the Summer Health Professions Education Program
Xirau-Probert, P., Lai, T., Black, E., Fanfan, D., Blue, A., Rush, C. C., Powers, R., & Stacciarini, J.-M. R. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.52440 · Cited by 8 · see citing works
- Authors
- Shaw, N. M., Hills, N., Holler, J., Fernandez, A., Davis, D., Palmer, N. R., Sliwka, D., & Breyer, B. N.
- Affiliations
- University of California, San Francisco (US)
- Harvard University (US)
- San Francisco General Hospital (US)
- Corresponding author
- Breyer, Benjamin N.
- Venue
- Journal of Racial and Ethnic Health Disparities
- Published
- 2023-06-21
- Volume
- 11
- Issue
- 4
- Pages
- 2083-2092
- ISSN
- 2196-8837 (ISSN-L)
- 2197-3792
- OpenAlex
- W4381470577
- Cited by
- 17
- References
- 3
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 5
- FWCI
- 5.13
- Type
- journal article
- Language
- en
- Open access
- green
- escholarship.org
- Licence
- Locations
- Journal of Racial and Ethnic Health Disparities (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Funders
- University of California, San Francisco
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Social Sciences › Gender Studies › Diversity and Career in Medicine
- Keywords
- gender concordance, patient satisfaction, outpatient visits, CAHPS, telemedicine, racial disparities in health care, physician incentives
- MeSH terms
- Adult, Aged, Ambulatory Care Facilities, Ethnicity, Female, Humans, Male, Middle Aged, Physician-Patient Relations, Sex Factors, Patient Satisfaction, Racial Groups
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