Do patients choose physicians of their own race?

Health Affairs

Volumn 19, Issue 4, 2000, Pages 76-83

  Saha, Somnath ^a   Taggart, Sara H ^b   Komaromy, Miriam ^c   Bindman, Andrew B ^d  

^a OREGON HEALTH AND SCIENCE UNIVERSITY   (United States)

^b UNIVERSITY OF WASHINGTON   (United States)

^c UNIVERSITY OF CALIFORNIA   (United States)

^d SAN FRANCISCO GENERAL HOSPITAL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AFRICAN AMERICAN; ARTICLE; CAUCASIAN; DOCTOR PATIENT RELATION; ETHNIC GROUP; FEMALE; HEALTH CARE DELIVERY; HISPANIC; HUMAN; MALE; MIDDLE AGED; PATIENT ATTITUDE; PSYCHOLOGICAL ASPECT; SOCIAL PROBLEM; STATISTICS; UNITED STATES;

ADULT; AFRICAN AMERICANS; ETHNIC GROUPS; EUROPEAN CONTINENTAL ANCESTRY GROUP; FEMALE; HEALTH SERVICES ACCESSIBILITY; HISPANIC AMERICANS; HUMANS; MALE; MIDDLE AGED; PATIENT ACCEPTANCE OF HEALTH CARE; PHYSICIAN-PATIENT RELATIONS; RACE RELATIONS; UNITED STATES;

EID: 0002235377     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.19.4.76     Document Type: Article

References (27)

1. Association of American Medical Colleges, Minority Students in Medical Education, no. 11 (Washington: AAMC, 1998).
2. Council on Graduate Medical Education, Minorities in Medicine, Twelfth Report (Rockville, Md.: COGME/Health Resources and Services Administration, 1998); H.W. Nickens, "The Rationale for Minority-Targeted Programs in Medicine in the 1990s," Journal of the American Medical Association 267, no. 17 (1992): 2390, 2395; Bureau of Health Professions, Minority Physicians: A Profile (Washington: U.S. Government Printing Office, 1993); and Council on Ethical and Judicial Affairs, American Medical Association, "Black-White Disparities in Health Care," Journal of the American Medical Association 263, no. 17 (1990): 2344-2346. The AAMC defines underrepresnted minorities as blacks, Mexican Americans, mainland Puerto Ricans, and Native Americans. In this paper the term refers only to these groups, while minority also includes other Hispanics.
3. Council on Graduate Medical Education, Minorities in Medicine, Twelfth Report (Rockville, Md.: COGME/Health Resources and Services Administration, 1998); H.W. Nickens, "The Rationale for Minority-Targeted Programs in Medicine in the 1990s," Journal of the American Medical Association 267, no. 17 (1992): 2390, 2395; Bureau of Health Professions, Minority Physicians: A Profile (Washington: U.S. Government Printing Office, 1993); and Council on Ethical and Judicial Affairs, American Medical Association, "Black-White Disparities in Health Care," Journal of the American Medical Association 263, no. 17 (1990): 2344-2346. The AAMC defines underrepresnted minorities as blacks, Mexican Americans, mainland Puerto Ricans, and Native Americans. In this paper the term refers only to these groups, while minority also includes other Hispanics.
4. Council on Graduate Medical Education, Minorities in Medicine, Twelfth Report (Rockville, Md.: COGME/Health Resources and Services Administration, 1998); H.W. Nickens, "The Rationale for Minority-Targeted Programs in Medicine in the 1990s," Journal of the American Medical Association 267, no. 17 (1992): 2390, 2395; Bureau of Health Professions, Minority Physicians: A Profile (Washington: U.S. Government Printing Office, 1993); and Council on Ethical and Judicial Affairs, American Medical Association, "Black-White Disparities in Health Care," Journal of the American Medical Association 263, no. 17 (1990): 2344-2346. The AAMC defines underrepresnted minorities as blacks, Mexican Americans, mainland Puerto Ricans, and Native Americans. In this paper the term refers only to these groups, while minority also includes other Hispanics.
5. Council on Graduate Medical Education, Minorities in Medicine, Twelfth Report (Rockville, Md.: COGME/Health Resources and Services Administration, 1998); H.W. Nickens, "The Rationale for Minority-Targeted Programs in Medicine in the 1990s," Journal of the American Medical Association 267, no. 17 (1992): 2390, 2395; Bureau of Health Professions, Minority Physicians: A Profile (Washington: U.S. Government Printing Office, 1993); and Council on Ethical and Judicial Affairs, American Medical Association, "Black-White Disparities in Health Care," Journal of the American Medical Association 263, no. 17 (1990): 2344-2346. The AAMC defines underrepresnted minorities as blacks, Mexican Americans, mainland Puerto Ricans, and Native Americans. In this paper the term refers only to these groups, while minority also includes other Hispanics.
6. See, for example, S.N. Keith et al., "Effects of Affirmative Action in Medical Schools: A Study of the Class of 1975," New England Journal of Medicine 313, no. 24 (1985): 1519-1525; E. Moy and B.A. Bartman, "Physician Race and Care of Minority and Medically Indigent Patients," Journal of the American Medical Association 273, no. 16 (1995): 1515-1520; and M. Komaromy et al., "The Role of Black and Hispanic Physicians in Providing Health Care for Underserved Populations," New England Journal of Medicine 334, no. 20 (1996): 1305-1310.
7. See, for example, S.N. Keith et al., "Effects of Affirmative Action in Medical Schools: A Study of the Class of 1975," New England Journal of Medicine 313, no. 24 (1985): 1519-1525; E. Moy and B.A. Bartman, "Physician Race and Care of Minority and Medically Indigent Patients," Journal of the American Medical Association 273, no. 16 (1995): 1515-1520; and M. Komaromy et al., "The Role of Black and Hispanic Physicians in Providing Health Care for Underserved Populations," New England Journal of Medicine 334, no. 20 (1996): 1305-1310.
8. See, for example, S.N. Keith et al., "Effects of Affirmative Action in Medical Schools: A Study of the Class of 1975," New England Journal of Medicine 313, no. 24 (1985): 1519-1525; E. Moy and B.A. Bartman, "Physician Race and Care of Minority and Medically Indigent Patients," Journal of the American Medical Association 273, no. 16 (1995): 1515-1520; and M. Komaromy et al., "The Role of Black and Hispanic Physicians in Providing Health Care for Underserved Populations," New England Journal of Medicine 334, no. 20 (1996): 1305-1310.
9. W. Sunman, "Affirmative Action," Lancet 335, no. 9155 (1999): 845.
10. Moy and Bartman, "Physician Race."
11. Komaromy et al., "The Role of Black and Hispanic Physicians."
12. We used random-digit dialing using a stratified sampling process to ensure proper representation of households from each of the forty-eight contiguous states and from central-city, suburban, and rural areas. Black and Hispanic Americans were oversampled through a process of screening multiple national cross-sections. Of the 3,789 respondents, 669 were Asian, Native American, or of nonspecified race and were excluded from our analyses because they were not sampled using a nationally representative framework. Among the remaining 3,120 respondents, 959 did not have a regular physician, including 31 percent of blacks, 41 percent of Hispanics, and 20 percent of whites. Another 116 did not identify their physician's race, leaving a final sample of 2,045 black, Hispanic, and white respondents with a regular physician of known race. To limit the effects of nonresponse, we weighed the data according to parameters from the most recently available census statistics. For a more detailed outline of survey methods, see Louis Harris and Associates, Health Care Services and Minority Groups: A Comparative Survey of Whites, African-Americans, Hispanics, and Asian-Americans (New York: Louis Harris and Associates, 1994).
13. Results obtained from logistic regression analysis using racial concordance as the dependent variable and the following independent variables: chose physician (yes/no), convenience of physician's practice location (four-point scale), age (years), sex, educational attainment, annual household income, primary language (English versus other), birthplace/years in U.S. (born in U.S.; immigrated more than twenty years ago, ten to twenty years ago, less than ten years prior to survey year), geographic region, urbanicity, insurance type, health maintenance organization membership (yes/no), primary care site (physician's office, public clinic, emergency department), sex of physician, and health status (four-point scale). A table of odds ratios with confidence intervals for these factors is available from the authors on request. Contact Somnath Saha, Medical Service (P3MED), Portland VA Medical Center, 3710 S.W. U.S. Veterans Hospital Road, Portland, Oregon 97207.
14. AAMC, Minority Students in Medical Education.
15. Nickens, "The Rationale for Minority-Targeted Programs."
16. U.S. Bureau of the Census, Population Projections of the United States by Age, Sex, Race, and Hispanic Origin: 1995 to 2050, Current Population Reports, Series P25-1130 (Washington: U.S. Department of Commerce, 1999).
17. D.L. Libby, Z. Zhou, and D.A. Kindig, "Will Minority Physician Supply Meet U.S. Needs?" Health Affairs (July/Aug 1997): 205-214.
18. AAMC, Minority Students in Medical Education.
19. For example, the AAMC's Project 3000 by 2000, a program launched in 1991, aimed at increasing the pool of qualified minority medical school applicants through a variety of mechanisms.
20. AAMC, Minority Students in Medical Education.
21. K. Srinivisan, "Fewer Minorities Entering U.S. Medical Schools; Rollback of Affirmative Action Is Blamed" (Associated Press, 2 November 1997); and D.M. Carlisle, J.E. Gardner, and H. Liu, "The Entry of Underrepresented Minority Students into U.S. Medical Schools: An Evaluation of Recent Trends," American Journal of Public Health 88, no. 9 (1998): 1314-1318.
22. K. Srinivisan, "Fewer Minorities Entering U.S. Medical Schools; Rollback of Affirmative Action Is Blamed" (Associated Press, 2 November 1997); and D.M. Carlisle, J.E. Gardner, and H. Liu, "The Entry of Underrepresented Minority Students into U.S. Medical Schools: An Evaluation of Recent Trends," American Journal of Public Health 88, no. 9 (1998): 1314-1318.
23. Texas implemented a program of guaranteeing admission to state universities for all high school students in Texas graduating in the top 10 percent of their class. California and Florida are proposing similar programs. See J. Wilgoren, "Texas' Top 10 Percent Law Appears to Preserve College Racial Mix," New York Times, 24 November 1999, Al.
24. See, for example, M. Lillie-Blanton and A. Alfaro-Correa, In the Nation's Interest: Equity in Access to Health Care (Washington: Joint Center for Political and Economic Studies, 1995); and AMA Council on Ethical and Judicial Affairs, "Black-White Disparities in Health Care."
25. See, for example, M. Lillie-Blanton and A. Alfaro-Correa, In the Nation's Interest: Equity in Access to Health Care (Washington: Joint Center for Political and Economic Studies, 1995); and AMA Council on Ethical and Judicial Affairs, "Black-White Disparities in Health Care."
26. S. Saha et al., "Patient-Physician Racial Concordance and the Perceived Quality and Use of Health Care," Archives of Internal Medicine 159, no. 9 (1999): 997-1004; and S. Woloshin et al., "Is Language a Barrier to the Use of Preventive Services?" Journal of General Internal Medicine 12, no. 8 (1997): 472-477.
27. S. Saha et al., "Patient-Physician Racial Concordance and the Perceived Quality and Use of Health Care," Archives of Internal Medicine 159, no. 9 (1999): 997-1004; and S. Woloshin et al., "Is Language a Barrier to the Use of Preventive Services?" Journal of General Internal Medicine 12, no. 8 (1997): 472-477.