https://in.bgu.ac.il/en/fohs/communityhealth/Family/Documents/DOCTOR-PATIENT%20COMMUNICATION%20A%20REVIEW%20OF.pdf

Doctor-patient communication: a review of the literature.

ContextMany studies have documented race and gender differences in health care
received by patients. However, few studies have related differences in the
quality of interpersonal care to patient and physician race and gender.ObjectiveTo describe how the race/ethnicity and gender of patients and physicians
are associated with physicians' participatory decision-making (PDM) styles.Design, Setting, and ParticipantsTelephone survey conducted between November 1996 and June 1998 of 1816
adults aged 18 to 65 years (mean age, 41 years) who had recently attended
1 of 32 primary care practices associated with a large mixed-model managed
care organization in an urban setting. Sixty-six percent of patients surveyed
were female, 43% were white, and 45% were African American. The physician
sample (n=64) was 63% male, with 56% white, and 25% African American.Main Outcome MeasurePatients' ratings of their physicians' PDM style on a 100-point scale.ResultsAfrican American patients rated their visits as significantly less participatory
than whites in models adjusting for patient age, gender, education, marital
status, health status, and length of the patient-physician relationship (mean
[SE] PDM score, 58.0 [1.2] vs 60.6 [3.3]; P=.03).
Ratings of minority and white physicians did not differ with respect to PDM
style (adjusted mean [SE] PDM score for African Americans, 59.2 [1.7] vs whites,
61.7 [3.1]; P=.13). Patients in race-concordant relationships
with their physicians rated their visits as significantly more participatory
than patients in race-discordant relationships (difference [SE], 2.6 [1.1]; P=.02). Patients of female physicians had more participatory
visits (adjusted mean [SE] PDM score for female, 62.4 [1.3] vs male, 59.5
[3.1]; P=.03), but gender concordance between physicians
and patients was not significantly related to PDM score (unadjusted mean [SE]
PDM score, 76.0 [1.0] for concordant vs 74.5 [0.9] for discordant; P=.12). Patient satisfaction was highly associated with PDM score within
all race/ethnicity groups.ConclusionsOur data suggest that African American patients rate their visits with
physicians as less participatory than whites. However, patients seeing physicians
of their own race rate their physicians' decision-making styles as more participatory.
Improving cross-cultural communication between primary care physicians and
patients and providing patients with access to a diverse group of physicians
may lead to more patient involvement in care, higher levels of patient satisfaction,
and better health outcomes.

https://jamanetwork.com/journals/jama/articlepdf/191132/JRP90001.pdf

Race, gender, and partnership in the patient-physician relationship.

The effect of patient race and socio-economic status on physicians' perceptions of patients.

Assessing the Nutritional Status of the Elderly: the Mini Nutritional Assessment as Part of the Geriatric Evaluation

The measurement of satisfaction with healthcare: implications for practice from a systematic review of the literature.

Nutritional status in a healthy elderly population: dietary and supplemental intakes.

The behavior of 15 internal medicine residents, each with 10 patients, was observed through a one-way mirror. Ratings by the patients of satisfaction with their physicians were also obtained. Patient satisfaction correlated strongly with ratings for physician courtesy and information-giving, Nonverbal behaviors such as eye contact, bodily positioning, and physical contact did not correlate with patient satisfaction. The correlations between physician behavior and patient satisfaction did not hold for the four women physicians studied.

Physician behaviors that correlate with patient satisfaction.

We examined whether four patient characteristics (age, ethnicity, sex and appearance) influenced five physician behaviors with the patient (interviewing, nonverbal attention, courtesy, information giving and empathy). Ten physician-patient interactions were observed through a one-way mirror for each of 15 physicians. Physicians were rated higher on information giving (p = 0.002) and empathic skills (p = 0.02) when they were with female patients; on interviewing (p = 0.02) and empathy (p = 0.0007) with Anglo-American compared with Spanish-American patients; on interviewing (p = 0.01), nonverbal attention (p = 0.001) and courtesy (p = 0.02) when with the best groomed patients; and on courtesy (p = 0.03) with elderly patients. In addition, there were fewer physician-initiated interruptions with female patients (p = 0.03) and with well-groomed patients (p = 0.02). Each of the four patient characteristics studied acted independently in influencing physician behavior. The recognition that patient characteristics influence physician behavior should stimulate physicians to examine their reactions in order to insure that all types of patients receive thorough, courteous and empathic care.

Patient Characteristics That Influence Physician Behavior

A high frequency of donations by some blood donors has prompted concern about iron depletion. Five hundred sixteen female and 505 male donors were examined by measurements of hemoglobin, hematocrit, plasma iron, total iron-binding capacity, and ferritin values and detailed histories of iron ingestion, pregnancy and menstrual status, and past blood donations. Hemoglobin, hematocrit, and serum iron studies, unlike ferritin values, were not sensitive indicators of body iron depletion. Reduced iron stores were found in 8% of male and 23% of female donors. Menstruation significantly lowered iron stores in women. The total number of lifetime donations was not as predictive of decreased iron stores as frequency of donations per year. Even casual iron supplementation reduced the impact of donations on iron stores. Administration of iron to donors, especially menstruating women, should be studied by blood programs. ( JAMA 1981;245:2038-2043)

Iron stores in blood donors.

Vitamin status may be related to serum lipid-lipoprotein levels. We tested this hypothesis in a group of 270 healthy elderly men and women over 60 years of age. Vitamin status was determined from dietary intakes and biochemical analysis of plasma. Fasting lipid profile included triglycerides, total cholesterol, low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein-cholesterol (HDL-C). Correlations have been adjusted by partial correlation for age, physical activity, body mass index, and alcohol consumption. Neither vitamin E intake nor ascorbic acid intake nor ascorbic acid plasma levels correlated with any lipids measured. HDL-C levels did not correlate with any vitamin parameters. In men, vitamin A blood levels correlated with LDL-C, triglyceride, and total cholesterol levels. In women, total cholesterol levels correlated inversely with thiamine and riboflavin blood status and with dietary intake of vitamins B6, D, and niacin. LDL-C plasma values were also inversely correlated with both intake and plasma vitamin D levels and intakes of riboflavin and vitamin B12 in women.

Elizabeth M. Hooper

Papers

Nutritional status in a healthy elderly population: dietary and supplemental intakes.

Physician behaviors that correlate with patient satisfaction.

Patient Characteristics That Influence Physician Behavior

Iron stores in blood donors.

Vitamins, lipids and lipoproteins in a healthy elderly population.