BACKGROUND: This review's goal was to determine how differences between physicians and patients in race, ethnicity and language influence the quality of the physician-patient relationship.

METHODS: We performed a literature review to assess existing evidence for ethnic and racial disparities in the quality of doctor-patient communication and the doctor-patient relationship.

RESULTS: We found consistent evidence that race, ethnicity; and language have substantial influence on the quality of the doctor-patient relationship. Minority patients, especially those not proficient in English, are less likely to engender empathic response from physicians, establish rapport with physicians, receive sufficient information, and be encouraged to participate in medical decision making.

CONCLUSIONS: The literature calls for a more diverse physician work force since minority patients are more likely to choose minority physicians, to be more satisfied by language-concordant relationships, and to feel more connected and involved in decision making with racially concordant physicians. The literature upholds the recommendation for professional interpreters to bridge the gaps in access experienced by non-English speaking physicians. Further evidence supports the admonition that "majority" physicians need to be more effective in developing relationships and in their communication with ethnic and racial minority patients.