Communication between South Asian patients and GPs: comparative study using the Roter Interactional Analysis System.

BACKGROUND The UK South Asian population has poorer health outcomes. Little is known about their process of care in general practice, or in particular the process of communication with GPs. AIM To compare the ways in which white and South Asian patients communicate with white GPs. DESIGN OF STUDY Observational study of video-recorded consultations using the Roter Interactional Analysis System (RIAS). SETTING West Yorkshire, UK. METHOD One hundred and eighty-three consultations with 11 GPs in West Yorkshire, UK were video-recorded and analysed. RESULTS Main outcome measures were consultation length, verbal domination, 16 individual abridged RIAS categories, and three composite RIAS categories; with comparisons between white patients, South Asian patients fluent in English and South Asian patients nonfluent in English. South Asians fluent in English had the shortest consultations and South Asians non-fluent in English the longest consultations (one-way ANOVA F = 7.173, P = 0.001). There were no significant differences in verbal domination scores between the three groups. White patients had more affective (emotional) consultations than South Asian patients, and played a more active role in their consultations, as did their GPs. GPs spent less time giving information to South Asian patients who were not fluent in English and more time asking questions. GPs spent less time giving information to South Asian patients fluent in English compared with white patients. CONCLUSIONS These findings were expected between patients fluent and non-fluent in English but do demonstrate their nature. The differences between white patients and South Asian patients fluent in English warrant further explanation. How much of this was due to systematic differences in behaviour by the GPs, or was in response to patients' differing needs and expectations is unknown. These differences may contribute to differences in health outcomes.