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Most minority patients cared for by non-white docs

Using data from a 2010 U.S. survey, researchers found that about 54 percent of minority patients report their doctors are not white. That number was even greater - about 70 percent - among non-English speaking patients.

"Among patients who fell into one of our disadvantage categories . . . These individuals were more likely than other patients to be served by a minority physician," Dr. Lyndonna Marrast said.

Marrast, who led the new analysis, is a fellow in general internal medicine and a physician at Cambridge Health Alliance in Massachusetts.

For the new study, she and her colleagues used data from 7,070 people who identified a physician on the 2010 Medical Expenditure Panel Survey.

They then estimated the odds for minority, low-income, Medicaid, uninsured and non-English speaking patients of having a non-white doctor.

Compared to white patients, the researchers found that minority, low-income, Medicaid and non-English speaking patients were more than five times more likely to see a non-white doctor, compared to non-Hispanic white patients.

Uninsured patients, however, were just as likely to see a non-white doctor as a white patient.

The numbers can be seen as an update to a similar study conducted in 1987, Marrast said. That study, the researchers write in JAMA Internal Medicine, found that non-white doctors were more likely to care for underserved and sicker patients.

"What's new is that we comment on Hispanic physicians, which is particularly important because of the increase in the Hispanic population, and we report on people who report not speaking English at home," Marrast said.

Because non-white doctors care for a majority of underserved patients, she and her colleagues suggest that increasing the number of non-white doctors may help alleviate concerns over doctor shortages brought on by the large number of low-income and uninsured adults soon-to-be covered under the Affordable Care Act, commonly known as Obamacare.

In an editorial accompanying the new analysis, Dr. Somnath Saha of the Portland VA Medical Center in Oregon, wrote that simply training more doctors will not meet the nation's growing needs.

"We should be deliberately selecting and training physicians who will go into undersupplied specialties . . . serve vulnerable patient populations . . . and practice in underserved communities," he wrote.

Marrast cautioned, however, that creating a more diverse doctor workforce is not a quick solution.

"We just want to call attention to this again, because it takes time to produce a physician," she said.

For example, initiatives would need to be started when children are in elementary and high school to prepare them for college and a medical education.

"Ideally we would live in integrated neighborhoods, where everyone has equal access to healthcare, but we don't," she said.

"Training more minority physicians is really one solution of many that can be implemented until larger societal changes occur."

SOURCE: http://bit.ly/MbBLb9 JAMA Internal Medicine, online December 30, 2013


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