The effect of a racially consonant medical context on reaction to physical handicap stemming from disease is explored in a sample of 90 African-American patients with vitiligo, a disfiguring skin disorder. The adjustment of sixty-nine patients in a predominantly black hospital setting is compared to that of twenty-one patients in a predominantly white hospital setting. The patients in the predominantly black clinic, where the physicians, staff, and clientele are African-American, show significantly better adjustment than do African-American patients in a medical context that is primarily white. Interviews with a random sample of one-third of the patients in each clinic show that patients are significantly more positive to black physicians and a black hospital setting and that other patients of the same race provide informal networks of support, as does the predominantly African-American community in which the hospital is located. Implications for both medical theory and practice are suggested on the basis of these findings.