After viewing the delivery of the prevention message, more in each group, except for African Americans, chose a video doctor of a different race. In addition, at final selection, 57% of Asian and other-race participants chose a non– European American video doctor. With regard to sex, most males and females chose a female video doctor at the initial selection, and even more did so at the final selection. These data suggested that many healthcare consumers are in concordance with the recent shift toward a more diverse population of physicians and that the white male physician may no longer be viewed as the stereotypical medical professional.
The qualities patients seek in a doctor
The assessment scores for the video doctors indicated that participants were choosing, both on first impressions and after further exposure, video doctors who they perceived to possess the qualities associated with patient-centered care.21,22 Although the overall ranking of the 6 video doctors was unchanged from initial to final selection, after viewing the delivery of the prevention message, many participants altered their choices: more males and females chose a female video doctor; more European American and Latino participants shifted from same-race to different-race video doctors; and more Asian and other-race participants shifted from European American to non–European American video doctors.
These findings suggested that, even in brief meetings with physicians, patients respond to a combination of patient-centered qualities and that this combination may carry more weight than the physician’s sex and race. In other words, from the point of view of the public at large, physicians of both sexes and all races can possess the desired physician qualities, and people may be receptive to any physician who exhibits these qualities.
Preference for a female doctor
Our finding that men and women in our sample preferred a female video doctor contrasts with sex preference findings from previous studies,3,6,8,10,11 although in general studies on sex preference of physicians have shown inconsistent findings. The female preference finding in our study may represent evolving positive attitudes toward and increasing familiarity with female physicians. From 1971 to 1991, the percentage of women first-year medical school students rose from 13.7% to 39.8%.14
The strong female preference also may represent sex stereotyping. Patients reported that they desire physicians who are sensitive to their needs and circumstances, deliver a warm and empathic style of care,15 invite participation in decision making,16 engage in emotionally focused talk, and provide health information within patients’ social, emotional, and cultural contexts.17 Other studies found that women, when compared with men, provide a style of care that approximates these patient-centered characteristics.18-20
Our participants, many of whom preferred female video doctors even at first, may have strongly associated a patient-centered, empathic style with being female. The particular female actors we chose also may have been better able to exhibit, regardless of our efforts to standardize, the combination of professional and personal skills most desired in a doctor.
Racial preferences
The preference for a same-race video doctor may have several origins. People may feel more familiar and comfortable with race-concordant relationships in general and may believe that a physician of one’s own race can better attend to specific health concerns. Same-race preference also may arise from the desire to avoid a racially prejudiced physician. Racially concordant as opposed to discordant care has been associated with increased patient satisfaction and use of health care services and with higher ratings from patients regarding their level of participation during physician visits.16,23
As indicated in our study and others, African Americans express a stronger preference than do individuals from other racial groups for receiving care from physicians of their own race.23 To support patients in exercising their racial preferences, some health care professional organizations, such as the National Medical Association, have provided a toll-free number that patients can call to locate a local African American physician.
Limitations of the study
The study had several limitations. We may not have successfully held constant the actors’ personalities and acting abilities. Future video doctor studies about patients’ acceptance regarding physicians’ race and sex could address this drawback by including multiple video doctors in each sex and race category.
Because only English-speaking participants were included in the study, we do not know whether Latinos who spoke only Spanish would have chosen differently. Our study also used a convenience sample in a San Francisco Bay Area shopping mall, and our results may not be generalizable to other populations.
We were unable to study the same-race preferences of the Asian participants in our sample. Because more than 10% of physicians practicing in the United States are of Asian ancestry, patients’ receptivity to Asian physicians and Asian patients’ preference for a same-race physician would be important research topics. Diversity of language and culture among various Asian and other ethnicities also could be addressed with a well-designed video doctor study. The absence of an Asian video doctor, however, did allow us to examine the selections made by participants when no same-race video doctor was available.