Metro

  • Written by Ryan Huerto, Family Medicine Physician, Health Services Researcher, Clinical Lecturer, University of Michigan

In today’s America, minority patients still have markedly worse health outcomes than white patients. The differences are greatest for black Americans: Compared to white patients, they are two to three times as likely to die of preventable heart disease and stroke[1]. They also have higher rates of cancer, asthma, influenza, pneumonia, diabetes, HIV/AIDS and homicide. For many of them, structural racism[2] and unequal treatment[3] remain a contributing factor to disease and death.

I am a physician who studies health disparities and ways to improve health care delivery[4]. My work focuses on people of color, including those who are black and indigenous. Improving health care delivery for these groups of people is a complicated and multi-layered task, but solutions exist. One of them is to increase the probability that minorities see doctors of their race or ethnicity, which I refer to as patient-provider racial and ethnic concordance. I have partnered with Prof. Edwin Lindo[5], a critical race theorist, to help explain why.

Building trust is key

In the current workforce, diversity among physicians is limited. That can lead to mistrust in doctor-patient relationships, even during routine checkups. Black patients, for instance, may feel more wary with a white doctor than a black doctor, and white doctors may feel less comfortable caring for minoritized patients. Mounting evidence suggests when physicians and patients share the same race or ethnicity, this improves time spent together[6], medication adherence[7], shared decision-making[8], wait times for treatment[9], cholesterol screening[10], patient understanding of cancer risk[11], and patient perceptions[12] of treatment decisions[13]. Not surprisingly, implicit bias[14] from the physician is decreased.

Minority patients benefit from having minority doctors, but that's a hard match to make Minority patients can expect better outcomes with a larger minority workforce. Getty Images / FS Productions[15]

A Stanford University study paired black men in Oakland, Calif., with either black or non-black doctors. The men seen by black physicians were more likely to engage with them[16], and even consent to preventive services like cardiovascular screenings and immunizations.

And, the study found that black doctors were more inclined to write detailed notes about their black patients. Those men who had the least trust in the medical system – and the least exposure to it – benefited the most from racial/ethnic concordance. The study estimates this approach could reduce the black-white mortality gap due to heart disease by 19%.

But what happened in Oakland is not going to happen anytime soon across the U.S. Based on the latest figures[17], white doctors make up 56% of the physician workforce, with Asian doctors at 17%. Just under 6% are Hispanic doctors. Only 5% are black doctors. Yet by 2042[18] – just over 20 years away – the combined minority population is set to become the majority in the U.S.

Based on those numbers, it will be difficult for the physician workforce to mirror the population in the near future. But given the benefits of a more diverse workforce, all educational and medical institutions – from grade school through completion of medical training – should invest in building a more diverse workforce.

Minority patients benefit from having minority doctors, but that's a hard match to make Adding nurses and support personnel who are minorities is also critical. Getty Images / Reza Estakhrian[19]

In the meantime, there is another way to augment patient-provider racial/ethnic concordance: Increase the presence of minority providers who are part of a team-based model of care, including registered nurses, doulas, certified nurse midwives and nurse practitioners.

Another way to potentially improve care for minority patients is to better understand the effect of other forms of patient-provider social concordance, such as shared immigrant status, religion, LGBTQ+ status, socioeconomic background or disability. Discordant patient-provider interactions can be improved by training more culturally[20] and structurally[21] competent doctors.

Finding a minority doctor

Since the health care workforce won’t reflect America’s true diversity anytime soon, here are a few tips to find a minority physician:

Ask family or friends for recommendations. Look for online photos posted by your health care provider, or request someone who speaks your native language. Check out the new phone apps: HUED[22] connects patients with minority physicians and offers patient reviews of them. Ayana[23] matches users with licensed mental health therapists based not only on race and ethnicity but disability and LGBTQ+ status.

If seeing a doctor who’s your race or ethnicity isn’t an option, there are still ways you can advocate for yourself in health care settings:

  • Write down your doctor’s name. Just knowing that can build rapport and increase accountability.

  • If you need a language interpreter[24], request one.

  • Bring family or friends with you. Studies show[25] that accompanying family and friends can serve as patient advocates and that their presence has a positive influence on building rapport and increasing patient participation according to doctors.

  • Ask for a chaperone[26] during physical exams. Like an interpreter, a patient request for a chaperone is widely accepted in today’s health care system.

  • Ask for and review documentation of your medical visit. You will need it in case of medical error, or if your physician wrongfully refuses to offer an appropriate service or treatment.

  • If you have a negative experience with a doctor, say something. Speak with a supervisor. Do something: Join a patient advisory council. Even giving feedback anonymously through a suggestion box helps. That can be enough to give employers adequate grounds to act on racist or difficult physicians. Positive feedback also helps; minority physicians too are subject to discrimination[27].

  • If you’re black and pregnant, create a birthing plan[28] and surround yourself with the best possible team of health care providers.

The ultimate goal, of course, is to achieve the best possible health outcomes for everyone, regardless of the race or ethnicity of patients and doctors. Minority patients should be able to trust their white physicians, and white physicians should be able to take equally good care of minoritized patients. Minoritized physicians should not bear the burden of eliminating health disparities. Until then? As long as structural racism exists within the health care industry, a minority patient should consider the benefits of a same-race or same-ethnicity doctor.

[ Get the best of The Conversation, every weekend. Sign up for our weekly newsletter[29]. ]

References

  1. ^ preventable heart disease and stroke (www.ncbi.nlm.nih.gov)
  2. ^ structural racism (www.ncbi.nlm.nih.gov)
  3. ^ unequal treatment (www.ncbi.nlm.nih.gov)
  4. ^ health disparities and ways to improve health care delivery (ihpi.umich.edu)
  5. ^ Prof. Edwin Lindo (depts.washington.edu)
  6. ^ time spent together (www.ncbi.nlm.nih.gov)
  7. ^ medication adherence (www.ncbi.nlm.nih.gov)
  8. ^ shared decision-making (www.ncbi.nlm.nih.gov)
  9. ^ wait times for treatment (www.ncbi.nlm.nih.gov)
  10. ^ cholesterol screening (www.ncbi.nlm.nih.gov)
  11. ^ cancer risk (www.ncbi.nlm.nih.gov)
  12. ^ patient perceptions (doi.org)
  13. ^ treatment decisions (www.ncbi.nlm.nih.gov)
  14. ^ implicit bias (www.ncbi.nlm.nih.gov)
  15. ^ Getty Images / FS Productions (www.gettyimages.com)
  16. ^ more likely to engage with them (siepr.stanford.edu)
  17. ^ the latest figures (www.aamc.org)
  18. ^ by 2042 (www.nytimes.com)
  19. ^ Getty Images / Reza Estakhrian (www.gettyimages.com)
  20. ^ culturally (www.ncbi.nlm.nih.gov)
  21. ^ structurally (www.ncbi.nlm.nih.gov)
  22. ^ HUED (afrotech.com)
  23. ^ Ayana (www.fastcompany.com)
  24. ^ language interpreter (www.floridahealth.gov)
  25. ^ Studies show (www.ncbi.nlm.nih.gov)
  26. ^ a chaperone (www.ama-assn.org)
  27. ^ discrimination (www.statnews.com)
  28. ^ birthing plan (www.self.com)
  29. ^ Sign up for our weekly newsletter (theconversation.com)

Authors: Ryan Huerto, Family Medicine Physician, Health Services Researcher, Clinical Lecturer, University of Michigan

Read more https://theconversation.com/minority-patients-benefit-from-having-minority-doctors-but-thats-a-hard-match-to-make-130504

Metropolitan republishes selected articles from The Conversation USA with permission

Visit The Conversation to see more

Entertainment News

Violin ReEnvisioned

Falling in love with music so young was more than transformative. Music became the lead sheet of my life; challenging me to navigate changes with grace, maintain a steady rhythmic groove, dynami...

Chelsey Green - avatar Chelsey Green

Kadda Sheekoff Win Best Urban Song For "All My Life"

Singer Kadda Sheekoff have emerged as the toast of the 2020 Songdew Pause&Play. Obviously, there are many composers who deserve the award more than Kadda Sheekoff, but the decision of the S...

Media Release - avatar Media Release

A Musical Journey: The Authentic Ted Cline

Ted Cline was born in 1962 as the 11th of 13 children.  His parents were hard-working tobacco share-croppers in Weston, Missouri. By the time he was eleven, he was sneaking downstairs to play his...

Ted Cline - avatar Ted Cline

Angela Predhomme - My Musical Journey

Determined to “make it” in the music industry as a songwriter, I meticulously crafted the best songs I could and pitched them to industry gatekeepers. “THIS one’s got to be IT,” I thought. But ala...

Angela Predhomme - avatar Angela Predhomme

GREYE: “So Far So Good”

“So Far So Good” After seven plus years firing up venues up and down the Atlantic Coast and throughout the Midwest to the breakneck tune of 90-110 annual shows, it’s definitely been jarring fo...

News Company - avatar News Company

The life and times of Wendy Moten

I never thought I would be in the music business, much less a recording artist. I never saw it coming. I thought I'd be a corporate attorney or something like that. Little did I know that anothe...

Wendy Moten - avatar Wendy Moten

CARY PARK “You Matter to Me”

“You Matter to Me” In any other time, Cary Park’s stunning new single “You Matter to Me” might be just another beautiful heartfelt love song, an outpouring of personal affection towards a cheri...

News Company - avatar News Company

TED CLINE ... Country Music Done Right

Country Music Done Right When Ted Cline uses the phrase “Country Music Done Right” to describe his engaging vibe, the Kansas City area-based singer/songwriter isn’t simply being crafty or clev...

News Company - avatar News Company

LAMONT DOZIER, JR. “Why Can’t We Be Lovers”/”I’m Gonna Take My Time”

When it comes to enduring musical legacies, it’s always inspiring when the melodic, grooving evergreen apples drop so close to the tree. The son and namesake of legendary singer, songwriter and re...

News Company - avatar News Company

Metropolitan Business News

MODEL/ACTOR THORN CASTILLO IS THE “NEW FACE” OF SCHICK STYLIST

In 2019, just as his multi-faceted career was taking off, Thorn Castillo heard Robert Downey Jr. offer a sage bit of advice during an interview on photographer/director Sam Jones’ acclaimed multi-...

News Company - avatar News Company

New Research Highlights Opportunities for Sports Betting

Revenue Stream for Sports’ Post-COVID-19 Recovery Strategies New Rochelle, NY, June 1, 2020— Twenty-four states have now legalized sports betting, with more states considering legalization la...

Len Stein - avatar Len Stein

How to make overseas transfers easier?

Mainstream banks can charge as much as $20 just to process a basic international money transfer. Fortunately, today people are not doomed to handling personal finances only through mainstream gl...

News Company - avatar News Company

The flourishing international market of fragrance and perfume

There is something special and unique about the art of fragrance. This is a big world and there are quite literally a lot of smells around at any given time. In fact, as one of the five human senses i...

News Company - avatar News Company

Impact of good marketing on sales

Sales and marketing are brothers as they go hand and in hand. The job of both of these departments is to generate revenue so that an organization can make money. A company that does not generate rev...

News Company - avatar News Company

7 effective tips for increasing sales in retail

It seems that retailers have drawn a difficult lot in the 21st century: competition from online retail is growing steadily. After all, Internet retailers can sell your products at significantly lowe...

News Company - avatar News Company

Holidays

5 COOL GADGETS TO CARRY FOR A SAFE TRIP

Are you planning to go on a trip? Possibly, you do not know what things are most necessary on a trip. In this article, we will guide you through some important tips. These tips help you to...

News Company - avatar News Company

New Baggage Regulations to Help Aussie Parents Travel with Infants

Travelling around the globe has never been easy, especially when infants tag along for the trip. One of the main issues that parents often have to deal with is the need to bring extra item...

News Company - avatar News Company

Maya Beach Opens to Tourists

Despite recent reports that Southern Thailand's famous Maya Beach will close for three months this year, in fact no decision to this effect has been made by Thai authorities. Phi Phi Nati...

Maevadi Rosenfeldt - avatar Maevadi Rosenfeldt