Provider communication quality: influence of patients' weight and race

OBJECTIVE: To examine the relationship between patient weight and provider communication quality and determine whether patient race/ethnicity modifies this association. METHODS: We conducted a cross-sectional analysis with 2009-2010 medical expenditures panel survey-household component (N=25,971). Our dependent variables were patient report of providers explaining well, listening, showing respect, and spending time. Our independent variables were patient weight status and patient weight-race/ethnicity groups. Using survey weights, we performed multivariate logistic regression to examine the adjusted association between patient weight and patient-provider communication measures, and whether patient race/ethnicity modifies this relationship. RESULTS: Compared to healthy weight whites, obese blacks were less likely to report that their providers explained things well (OR 0.78; p=0.02) or spent enough time with them (OR 0.81; p=0.04), and overweight blacks were also less likely to report that providers spent enough time with them (OR 0.78; p=0.02). Healthy weight Hispanics were also less likely to report adequate provider explanations (OR 0.74; p=0.04). CONCLUSION: Our study provides preliminary evidence that overweight/obese black and healthy weight Hispanic patients experience disparities in provider communication quality. PRACTICE IMPLICATION: Curricula on weight bias and cultural competency might improve communication between providers and their overweight/obese black and healthy weight Hispanic patients.