At a recent dental appointment, I was unexpectedly seen by a new provider in my longtime dentist’s practice. Early in the visit, he realized we were both Iranian American. Like me, he had been born and raised in the United States. We were both fluent English speakers and fully accustomed to navigating American medical settings.
After we briefly discussed how the war in Iran was affecting our families there, something shifted. The exchange was short, but deeply human. I left feeling an immediate sense of connection, trust and familiarity with a provider I had only just met.
That experience helped me better understand something I had long observed among immigrant families – that immigrant patients often seek out healthcare providers from similar backgrounds. What they are often seeking goes beyond a shared language or cultural familiarity.
I am a health administration professor and lawyer who studies how people navigate health systems. In my work, and through conversations with immigrant families, including my own, I have seen how subtle interactions in clinical settings can shape whether patients feel confident or dismissed and unsure about returning for care. For some, choosing a doctor with a similar background represents their best attempt to feel more understood.
The fact that many patients actively seek out providers who share aspects of their cultural background, even when doing so may require additional effort or limit their options, illustrates that it is not a minor preference, but a meaningful part of how people experience care.
Beyond a shared language
Immigrants make up a growing share of patients in the U.S., accounting for about 15% of the population.
Large national studies suggest that patients often seek providers with whom they share a cultural background. That choice is especially pronounced among racial and ethnic minority patients, those who speak a language other than English at home and those with public insurance.
Even as the U.S. physician workforce becomes more diverse, many patients still report difficulty finding providers who share their cultural or linguistic background. At the same time, some evidence suggests the number of foreign-born physicians may also be declining. In my view, that makes the effort to find such providers all the more noteworthy.
Dragos Condrea/iStock via Getty Images
A shared language may seem like the most obvious explanation for why immigrants seek out doctors from similar backgrounds. And in many cases, it does matter. When patients and clinicians speak the same language, communication improves and medical errors decline, especially for patients who are not fluent in English.
But language alone does not explain experiences like my own.
Narrative research on immigrant patients describes broader issues. For example, a patient might raise a concern about a persistent symptom, only to feel too quickly dismissed, or hear an explanation delivered in a simplified way that does not match their level of knowledge or experience.
These moments can be subtle, but as they accumulate over time, they may contribute to a sense that medical care feels transactional or dismissive rather than responsive to patients’ concerns. Even patients who are fully fluent in English and comfortable navigating the health system may come to expect not to be fully heard.
That expectation can shape where people feel comfortable seeking care.
Why shared background can matter
Sharing a background, whether through race, ethnicity, language or cultural experience, can sometimes help create a sense of connection – especially at the start of a relationship.
But research suggests the relationship is more nuanced than simply matching patients and doctors by identity. The way a doctor communicates, as well as whether they listen carefully, take concerns seriously and involve patients in decisions, also plays a central role.
In one study that examined physician-patient relationships across racial and ethnic groups, patients who felt personally similar to their physician – for example, in how the physician communicated, approached decisions or seemed to understand their concerns – were more likely to trust their doctor, feel satisfied with their care and follow medical advice.
Research on patient-centered care has similarly found that patients value interactions where they feel respected, understood and able to communicate openly.
Together, these studies suggest that while shared backgrounds can sometimes help create trust, communication and interpersonal connection may matter just as much.
More research is needed to understand how much these experiences reflect differences in communication itself versus connection spurred by a common background. But for immigrant patients, it may not be the shared identity itself that matters most, but the expectation that it will help them feel more easily understood. When patients consistently struggle to find that experience, shared background can become one of its few visible signals.
Understanding why immigrant patients make these choices ultimately reveals something more universal: Trust in medicine is shaped not only by clinical expertise, but by everyday human interaction. And patients value this quality so highly that they actively seek out providers who they believe will offer that sense of understanding and connection.
