Doctor-Patient Communication and Shared Decision Making with High-Risk Patients

Racial disparities exist in doctor-patient communication about serious illness, prognosis and treatment options. For example, it has been shown that goals of care discussions are significantly shorter when doctors talk to people of color compared to white patients. Other studies have shown that poor communication between white health care professionals and people of color leads to differences in the likelihood of completing treatment.

This project examines how to improve communication between white doctors and patients of color and how to build patients’ trust in their doctor. The project focuses on shared decision making with high-risk patients, i.e., cancer patients who have to choose between two treatment options that both have highly uncertain outcomes. Effective communication can be crucial for patients’ survival.

Hematologists will voluntarily participate in the study and will interact with trained actors of different races who will take on the role of patients. According to the scenario, the patient has been diagnosed with myeloid cancer and the hematologist presents the patient with treatment options, one of which includes allogeneic stem cell transplant. The interactions will be videorecorded and transcribed.The doctors’ verbal and non-verbal behavior will be coded on numerous relevant dimensions, and the actors will report their feelings during the interaction.

The next step is to establish a list of best practices and examine if there are differences in how the hematologists approach the shared decision making with white patients versus patients of color. This research will be the basis for developing an intervention aimed at promoting effective and unbiased communications between doctors and patients.

PRINCIPAL INVESTIGATOR

Markus Brauer, professor of psychology

CO-INVESTIGATORS

Molly Carnes, professor of medicine

Toby Campbell, professor of medicine