Parallel Realities: A Narrative Review of Differences Between Patients and their Care Providers

Differences in how patients and healthcare providers perceive, experience, and deliver care can undermine patient-centered care and health outcomes. Yet, few syntheses have examined these divergences as a primary focus. This narrative review aimed to identify and synthesize evidence on the differences between patients and their providers in terms of priorities, expectations, and experiences of care, and to explore how these differences can potentially influence relationships and outcomes. A database search was conducted to identify English-language studies published from January 2019 to January 2025 that included both patients and providers in the same sample and compared their perspectives. Data from 169 eligible studies were extracted using a structured template and analyzed thematically. Six domains of difference emerged: (1) clinical aspects of treatment; (2) care accessibility, availability, and safety; (3) information sharing and communication; (4) engagement and advocacy; (5) privacy and confidentiality; and (6) social support. Patients' perspectives were grounded in their lived and living experiences, relational meanings, and holistic definitions of quality, while providers' perspectives were shaped by biomedical training, procedural efficiency, and systemic constraints. These distinct epistemologies of care influenced perceptions of barriers, definitions of success, and the distribution of trust, sometimes producing epistemic injustice by undervaluing experiential knowledge. Findings suggest that bridging these divides requires structural and cultural change, integration of patient-sourced knowledge, shared decision-making models that redistribute epistemic authority, and relational approaches that address stigma and foster trust. Treating differences as a source of learning rather than a barrier can advance more equitable, responsive, and people-centered care.