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Objectives. We examined the association between patient race/ethnicity and patient–physician communication during medical visits. Methods. We used audiotape and questionnaire data collected in 1998 and 2002 to determine whether the quality of medical-visit communication differs among African American versus White patients. We analyzed data from 458 Af-rican American and White patients who visited 61 physicians in the Baltimore, Md–Washington, DC–Northern Virginia metropolitan area. Outcome measures that assessed the communication process, patient-centeredness, and emotional tone (affect) of the medical visit were derived from audiotapes coded by inde-pendent raters. Results. Physicians were 23 % more verbally dominant and engaged in 33 % less patient-centered communication with African American patients than with White patients. Furthermore, both African American patients and their physicians ex-hibited lower levels of positive affect than White patients and their physicians did. Conclusions. Patient–physician communication during medical visits differ