In this mobility-upheaval era, many health outcomes are shaped by transnational interactions among care-providers and recipients who meet in settings where nationality/ethnic match is a diminishing option. This exploratory study compares health-care outcomes in ethnoculturally discordant medical encounters according to patient national/ethnic identity, frequency (intensity) of medical consultation, and physician transnational competence (TC). Analysis is based on interviews with 35 political-asylum seekers and their ethnoculturally discordant clinicians at five reception centres in Finland. The three medical-encounter outcomes considered are patient-reported adherence with medication instructions, satisfaction, and confidence in the principal attending physician's recommendations. The intersubjectively assessed overall transnational competence of the attending physician provided the strongest association with all three outcome measures. The results of exploratory study suggest that preparing medical students with skills that can be applied effectively in variable transnational-encounter contexts would help close disparities in certain health-care outcomes. © Springer Science + Business Media, Inc. 2006.

Global health Physician-patient encounters Refugee health Transnational competence Patient satisfaction Finland Political asylum

doctor patient relation Cultural Diversity Physician-Patient Relations Finland refugee encounter group human Refugees Self Report Ethnic Groups controlled study priority journal Professional Competence interview Humans ethnic difference consultation male female Referral and Consultation cultural factor patient satisfaction Episode of Care Outcome Assessment (Health Care) Article patient compliance physician attitude adult exploratory research major clinical study outcome assessment Interviews skill medical student