Counseling About Traction Alopecia

A "Compliment, Discuss, and Suggest" Method

Ciara Grayson, MD; Candrice R. Heath, MD


Cutis. 2021;108(1):20-22. 

In This Article

Final Thoughts

Patient-centered communication is associated with the patient trusting the physician, which is especially important in race-discordant physician-patient relationships. A study found that patient-physician race discordance led to shorter visits, a lower rating of patient affect, and less shared decision-making.[8] Moreover, in a study of primary care clinicians, implicit bias was found to affect communication patterns and social interactions, impacting patient outcomes. Downstream effects of racial bias resulted in less speaking, smiling, and social comments when interacting with Black patients.[9]

These findings highlight the need to address interpersonal barriers to effective communication in racediscordant patient-physician dyads. A history of segregated neighborhoods and schools might contribute to structural barriers, resulting in lack of familiarity with cultural norms outside one’s culture, which might globally perpetuate poor communication and patient outcomes.

The “compliment, discuss, and suggest” method might lead to more positive physician-patient encounters by having the dermatologist focus on empathetically understanding the patient’s perspective.[10] Effective communication, understanding cultural hair care practices, and a thorough scalp examination are paramount for patients with tightly coiled hair.[11] Early intervention in TA is crucial and involves partnering with patients and parents to amend high-risk hairstyling routines with cultural humility.