OBJECTIVES: Prior studies suggest that enhanced communication skills among physicians treating patients from dissimilar backgrounds could increase patient benefits. While professional training in communication skills is beneficial, it may not fully substitute for the innate understanding that comes from shared racial/ethnic and gender experiences. Our study examines the impact of racial/ethnic and gender concordance between patients and doctors on medication adherence and medical testing adherence.

METHODS: Utilizing EHR data from an integrated health system, we analyzed patient records from chronic myeloid leukemia (CML) diagnoses between 2007 and 2019. We constructed longitudinal variables to measure treatment adherence via the continuous multiple-interval measure of gaps in medication (CM9) metric and biomarker testing adherence by the annual proportion of guideline-recommended tests. We evaluated concordance based on shared race/ethnicity and gender between patients and their primary care physicians (PCPs) and oncologists. We then assessed the correlation between concordance and adherence, controlling for patient comorbidities, income, initial treatment regimen, treatment duration, and physician experience.

RESULTS: Race/ethnicity and gender concordance of patients with oncologist significantly improved treatment adherence (5.0%, 95%CI (3.8%,6.2%)), while no effect was observed from patient-PCP concordance. Conversely, patient-PCP concordance exhibited higher testing adherence (4.0%, 95%CI (1.0%,6.2%)), with no effect observed from patient-oncologist concordance. Notably, female patients matched with female oncologists and PCPs showed higher treatment and testing adherence, respectively, compared to male patients matched with male oncologists and PCPs (7.9%, 95%CI: (6.1%,9.6%); 5.0%, 95%CI: (0.15%, 9.7%), respectively).

CONCLUSIONS: Our findings show that shared race/ethnicity and gender between patients and physicians positively impact adherence levels. Specialty-specific roles are pivotal; oncologists significantly affect treatment adherence, while PCPs are instrumental in biomarker testing adherence. These results highlight the role of patient-physician concordance, suggesting that beyond the improvement of communication skills, the diversification of the healthcare workforce may be a critical step in improving healthcare engagement and outcomes.