Objective: To examine patient preferences for age-,gender-, and racial/ethnic-concordant primary care physicians.
Design: Focus group interviews.
Patients and setting: Forty-nine adults (African Americans, Caucasians, and Latinos) receiving their outpatient medical care in university-based primary care clinics in Northern California.
Main measures and results: Guiding questions were designed to elicit information about what patients look for in establishing and maintaining a therapeutic relationship with a primary care physician. Patients were prompted to provide examples and to discuss demographic-concordance factors. Many participants felt that their continuity of care was poor and that they could not choose their own primary care physicians in the academic system. Most reported tolerating these inconveniences for what they perceived to be a higher quality of care linked to medical innovations at academic medical centers. Patients' views regarding age concordance were varied and unrelated to gender or racial/ethnic group. Women in all English-proficient groups described gender concordance as important to their relationships with primary care physicians. Spanish-speaking participants uniformly preferred Spanish-speaking providers. African-American participants and Spanish-speaking Latino men felt that race/ethnic concordance contributed to a practitioner's empathy, and some were concerned by the lack of race/ethnic- or language-concordant doctors.
Conclusions: Examining patients' preferences for patient-physician demographic concordance provides insight into the patient-physician relationship. Addressing areas where these preferences affect communication patterns and perceptions of quality of care may lead to overall improvements in patient-physician relationships and health outcomes.