When patients have a choice, they are likely to choose a doctor of the same race or ethnic background and they are more likely to be satisfied with their care, says a study in the .
The idea that patients prefer a doctor of their own race is common but had never been tested, said lead author Dr Thomas LaVeist, associate professor of health policy and management at the Bloomberg School of Public Health, Johns Hopkins University in Baltimore, Maryland.
The study reviewed data on 2720 patients in the 1994 Commonwealth Fund minority health survey, a nationally representative telephone sampling of adults aged 18 years and older living in the lower 48 states of the United States—that is, not including Alaska or Hawaii.
Patients with a usual source of medical care were asked how good a job their doctor did at providing good health care, treating them with dignity, making sure they understood what they had been told, listening to their health problems, and being accessible by telephone or in person. Answers were reported on a four point scale from poor to excellent.
The racial and ethnic categories included white, black, Hispanic, and Asian-American. Participants were asked how much choice they had in choosing a physician, because some health plans may allow little choice or assign a patient to a physician. They were also asked about English as a primary language, sex, age, income, education, and health insurance.
American physicians are overwhelmingly white, so many patients might have been unable to select a physician of the same race or ethnicity. Most patients in the study had white physicians, except for Asian-Americans, 52% of whom had an Asian- American physician.
However, only 21% of African-American patients and 19% of Hispanic patients had a doctor of the same race or ethnic group. Almost half of the patients surveyed (47%) had a doctor of the same race or ethnic group.
African-American, Hispanic, and Asian-American patients reported greater satisfaction with care if their doctor was of the same race or ethnic background than if their doctor was of a different background. White patients did not report lower satisfaction with African-American doctors, but the numbers were small. Patients who could choose their doctor were more likely to be of the same race as the doctor, compared with patients who could not choose.
The authors suggest that patients choose a doctor of the same race because they feel greater comfort and trust with such a physician. They may distrust physicians of a different race or may be reacting to past experiences.
Figure.
CC STUDIO/SPL
One in five African Americans has a doctor of the same ethnic group