This article examines barriers to provider-patient partnership for low
er-income black households in the rural South. After providing an inte
ractional model of partnership, quality of provider-patient interactio
n is assessed for private practice, clinic, inpatient hospital, and em
ergency department settings across five counties. Quantitative and qua
litative data were collected through 281 household interviews, 20 key
informant interviews, and 6 focus group interviews. Findings suggest t
hat attention needs to be given to provider-patient communication and
the emergency department as a treatment setting. Respondents often bel
ieved that racism and classism were barriers to quality care in their
communities. Recommendations are presented based on these findings.