Racial Concordance and the Assumption of Trust: Why Engagement Is Often Mistaken for Partnership in the Care of Black Men

Samantha Faith Calhoun, Acute, Chronic, and Continuing Care Science Department, Loewenberg College of Nursing, The University of Memphis, Memphis, TennesseeFollow
Lacretia Carroll, Strategic Communication Education and Outreach, St. Jude Children's Hospital, Memphis, Tennessee, USA
Y'Esha Williams-Click, Family, Community, and Health System Science Department, Loewenberg College of Nursing, The University of Memphis, Memphis, Tennessee
Kola Brown, Department of Counseling, Educational Psychology and Research, University of Memphis, Memphis, Tennessee, USA

ORCID

Samantha Faith Calhoun: https://orcid.org/0000-0002-2532-3135

Lacretia Carroll: https://orcid.org/0000-0002-3989-1352

Abstract

Race concordance between patients and clinicians is frequently promoted as a strategy to improve trust and engagement for Black men in healthcare. Evidence suggests that encounters with Black male clinicians often increase patient comfort and observable engagement; however, engagement alone does not necessarily reflect trust. Drawing on professional experience as a nurse and researcher working with Black men, and on prior research examining shared decision-making preferences among Black men with hypertension in the U.S. Mid-South, this Personal Narrative examines how race-concordant encounters may rely on presumed trust, leading clinicians to advance diagnosis and treatment planning without adequate co-construction of care. When engagement is conflated with trust, Black men may appear receptive while remaining insufficiently involved in clinical decision-making. Recent evidence further suggests that high-quality shared decision-making (SDM) is independently associated with reduced healthcare expenditures, and that these effects are amplified within racially concordant relationships, findings that underscore the imperative to move beyond surface-level engagement. This article argues that trust must be deliberately cultivated through practices that assess patient knowledge, elicit preferences, and support shared decision-making. Evidence-informed recommendations are presented to support clinicians and healthcare leaders in strengthening patient-clinician partnerships and advancing equitable patient experience for Black men.

Recommended Citation

Calhoun S, Carroll L, Williams-Click Y, Brown K. Racial Concordance and the Assumption of Trust: Why Engagement Is Often Mistaken for Partnership in the Care of Black Men. Patient Experience Journal. ; 13(2):24-28. doi: 10.35680/2372-0247.2123.