"We'll Get to You When We Get to You": Exploring Potential Contributions of Health Care Staff Behaviors to Patient Perceptions of Discrimination and Satisfaction.
OBJECTIVE
We qualitatively assessed patients' perceptions of discrimination and patient satisfaction in the health care setting specific to interactions with nonphysician health care staff.


METHODS
We conducted 12 focus-group interviews with African American and European American participants, stratified by race and gender, from June to November 2008. We used a topic guide to facilitate discussion and identify factors contributing to perceived discrimination and analyzed transcripts for relevant themes using a codebook.


RESULTS
We enrolled 92 participants: 55 African Americans and 37 European Americans, all of whom reported perceived discrimination and lower patient satisfaction as a result of interactions with nonphysician health care staff. Perceived discrimination was associated with 2 main characteristics: insurance or socioeconomic status and race. Both verbal and nonverbal communication style on the part of nonphysician health care staff were related to individuals' perceptions of how they were treated.


CONCLUSIONS
The behaviors of nonphysician health care staff in the clinical setting can potentially contribute to patients' perceptions of discrimination and lowered patient satisfaction. Future interventions to reduce health care discrimination should include a focus on staff cultural competence and customer service skills.
Gabriel S. Tajeu is with the Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham. Andrea L. Cherrington, Lynn Andreae, and Candice Prince are with the Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham. Cheryl L. Holt is with the Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park. Jewell H. Halanych is with the Department of Internal Medicine, University of Alabama School of Medicine, Montgomery.
Gabriel S
GS
Tajeu
Gabriel S. Tajeu is with the Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham. Andrea L. Cherrington, Lynn Andreae, and Candice Prince are with the Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham. Cheryl L. Holt is with the Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park. Jewell H. Halanych is with the Department of Internal Medicine, University of Alabama School of Medicine, Montgomery.
Andrea L
AL
Cherrington
Gabriel S. Tajeu is with the Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham. Andrea L. Cherrington, Lynn Andreae, and Candice Prince are with the Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham. Cheryl L. Holt is with the Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park. Jewell H. Halanych is with the Department of Internal Medicine, University of Alabama School of Medicine, Montgomery.
Lynn
L
Andreae
Gabriel S. Tajeu is with the Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham. Andrea L. Cherrington, Lynn Andreae, and Candice Prince are with the Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham. Cheryl L. Holt is with the Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park. Jewell H. Halanych is with the Department of Internal Medicine, University of Alabama School of Medicine, Montgomery.
Candice
C
Prince
Gabriel S. Tajeu is with the Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham. Andrea L. Cherrington, Lynn Andreae, and Candice Prince are with the Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham. Cheryl L. Holt is with the Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park. Jewell H. Halanych is with the Department of Internal Medicine, University of Alabama School of Medicine, Montgomery.
Cheryl L
CL
Holt
Gabriel S. Tajeu is with the Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham. Andrea L. Cherrington, Lynn Andreae, and Candice Prince are with the Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham. Cheryl L. Holt is with the Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park. Jewell H. Halanych is with the Department of Internal Medicine, University of Alabama School of Medicine, Montgomery.
Jewell H
JH
Halanych
D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D000407:Alabama; D000488:Allied Health Personnel; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011287:Prejudice; D011369:Professional-Patient Relations; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data