Doctor-patient communications in the Aboriginal community: towards the development of educational programs.
OBJECTIVE
Aboriginal people in Canada have poorer health than the rest of the population. Reasons for health disparities are many and include problems in communication between doctor and patient. The objective of this study was to understand doctor-patient communication in Aboriginal communities in order to design educational interventions for medical students based on the needs and experiences of patients.


METHODS
Experiences of good and poor communication were studied by semi-structured interviews or focus groups with 22 Aboriginal community members, 2 community health representatives and 2 Aboriginal trainee physicians. Transcribed data were coded and subjected to thematic analysis.


RESULTS
Positive and negative experiences of communicating with physicians fell into three broad and interrelated themes: their histories as First Nations citizens; the extent to which the physician was trusted; time in the medical interview.


CONCLUSIONS
Aboriginal peoples' history affects their communication with physicians; barriers may be overcome when patients feel they have a voice and the time for it to be heard.


CONCLUSIONS
Physicians can improve communication with Aboriginal patients by learning about their history, building trust and giving time.
Towle
Angela
A
Department of Medicine, Faculty of Medicine & Division of Health Care Communication, College of Health Disciplines, The University of British Columbia, 3250-910 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 4E3. atowle@interchange.ubc.ca
Godolphin
William
W
Alexander
Ted
T
D000328:Adult; D001294:Attitude to Health / Q000208:ethnology*; D001955:British Columbia; D002983:Clinical Competence / Q000592:standards; D003142:Communication; D018864:Cultural Diversity; D004645:Empathy; D005239:Fear / Q000523:psychology; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007198:Indians, North American / Q000193:education / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D020380:Needs Assessment; D010353:Patient Education as Topic / Q000458:organization & administration*; D010817:Physician-Patient Relations; D016730:Program Development; D036301:Qualitative Research; D012649:Self Concept; D011795:Surveys and Questionnaires; D013998:Time Perception; D035502:Trust / Q000523:psychology