Opportunities and challenges in discussing racism during primary care visits

OBJECTIVE: To understand how patients and primary care practitioners (PCPs) discuss racism and their perspectives on having these conversations during primary care visits. DATA SOURCES/STUDY SETTING: We conducted semi-structured interviews from September 2020-March 2021 at a Federally Qualified Health Center in the San Francisco Bay Area. STUDY DESIGN: We conducted an inductive qualitative descriptive pilot study using one-on-one, semi-structured interviews with 5 members of a Patient Advisory Council and 10 internal medicine PCPs. DATA COLLECTION/EXTRACTION METHODS: Interviews were conducted via video conferencing, recorded, and transcribed. An iterative analytic process was used to thematically assess participants' experiences and perspectives and identify key themes. PRINCIPAL FINDINGS: Patients and PCPs identified benefits from engaging in conversations about racism during primary care visits and noted challenges and concerns. Patients and PCPs highlighted strategies to advance communication about racism in primary care. CONCLUSIONS: Initiating conversations about racism with patients in primary care can be meaningful, but also has risks. More research is needed for deeper exploration of patients' perspectives and development of trainings. Improving how PCPs communicate with patients about racism represents an opportunity to advance antiracism in medicine and improve health outcomes for individuals who have historically been poorly served by our health care system.