Cultural differences in medical communication: a review of the literature

Patient Educ Couns. 2006 Dec;64(1-3):21-34. doi: 10.1016/j.pec.2005.11.014. Epub 2006 Jan 20.


Objective: Culture and ethnicity have often been cited as barriers in establishing an effective and satisfying doctor-patient relationship. The aim of this paper is to gain more insight in intercultural medical communication difficulties by reviewing observational studies on intercultural doctor-patient communication. In addition, a research model for studying this topic in future research is proposed.

Methods: A literature review using online databases (Pubmed, Psychlit) was performed.

Results: Findings reveal major differences in doctor-patient communication as a consequence of patients' ethnic backgrounds. Doctors behave less affectively when interacting with ethnic minority patients compared to White patients. Ethnic minority patients themselves are also less verbally expressive; they seem to be less assertive and affective during the medical encounter than White patients.

Conclusion: Most reviewed studies did not relate communication behaviour to possible antecedent culture-related variables, nor did they assess the effect of cultural variations in doctor-patient communication on outcomes, leaving us in the dark about reasons for and consequences of differences in intercultural medical communication. Five key predictors of culture-related communication problems are identified in the literature: (1) cultural differences in explanatory models of health and illness; (2) differences in cultural values; (3) cultural differences in patients' preferences for doctor-patient relationships; (4) racism/perceptual biases; (5) linguistic barriers. It is concluded that by incorporating these variables into a research model future research on this topic can be enhanced, both from a theoretical and a methodological perspective.

Practice implications: Using a cultural sensitive approach in medical communication is recommended.

Publication types

  • Review

MeSH terms

  • Attitude of Health Personnel / ethnology
  • Attitude to Health / ethnology
  • Communication*
  • Cross-Cultural Comparison
  • Cultural Characteristics
  • Cultural Diversity*
  • Empathy
  • Forecasting
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Individuality
  • Minority Groups / psychology
  • Models, Psychological
  • Motivation
  • Physician's Role / psychology
  • Physician-Patient Relations*
  • Prejudice
  • Research Design
  • Self Concept
  • Semantics
  • Social Identification
  • Social Values
  • Treatment Outcome
  • Verbal Behavior