The Role of Black and Hispanic Physicians in Providing Health Care for Underserved Populations
Open accessAbstract
BACKGROUND: Patients who are members of minority groups may be more likely than others to consult physicians of the same race or ethnic group, but little is known about the relation between patients' race or ethnic group and the supply of physicians or the likelihood that minority-group physicians will care for poor or black and Hispanic patients. METHODS: We analyzed data on physicians' practice locations and the racial and ethnic makeup and socioeconomic status of communities in California in 1990. We also surveyed 718 primary care physicians from 51 California communities in 1993 to examine the relation between the physicians' race or ethnic group and the characteristics of the patients they served. RESULTS: Communities with high proportions of black and Hispanic residents were four times as likely as others to have a shortage of physicians, regardless of community income. Black physicians practiced in areas where the percentage of black residents was nearly five times as high, on average, as in areas where other physicians practiced. Hispanic physicians practiced in areas where the percentage of Hispanic residents was twice as high as in areas where other physicians practiced. After we controlled for the racial and ethnic makeup of the community, black physicians cared for significantly more black patients (absolute difference, 25 percentage points; P < 0.001) and Hispanic physicians for significantly more Hispanic patients (absolute difference, 21 percentage points; P < 0.001) than did other physicians. Black physicians cared for more patients covered by Medicaid (P = 0.001) and Hispanic physicians for more uninsured patients (P = 0.03) than did other physicians. CONCLUSIONS: Black and Hispanic physicians have a unique and important role in caring for poor, black, and Hispanic patients in California. Dismantling affirmative-action programs as is currently proposed, may threaten health care for both poor people and members of minority groups.
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The study did not assess whether acceptance of public insurance varies between specialists who provide cognitive consultations and procedural or surgical specialists.
“Nor did we assess whether acceptance of public insurance varies between specialists who provide cognitive consultations and procedural or surgical specialists, who may be more dependent on their affiliated hospitals to provide technologically advanced diagnostic and surgical resources.29”
From Auditing Access to Specialty Care for Children with Public Insurance (2011) · cites this paper as [29]
The citing authors’ statement that they did not assess differences between specialist types describes their own study, not the cited paper. The cited paper’s Methods describe a survey of primary care physicians, and its Discussion addresses limitations concerning patient race and insurance status; neither section addresses whether procedural or surgical specialists depend more on affiliated hospitals for advanced resources. Searched for the specialist distinction and hospital-resource dependence. (LLM, conf=0.72)
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- Authors
- Komaromy, M., Grumbach, K., Drake, M., Vranizan, K., Lurie, N., Keane, D., & Bindman, A. B.
- Affiliations
- San Francisco General Hospital (US)
- University of California, San Francisco (US)
- University of Minnesota (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1996-05-16
- Volume
- 334
- Issue
- 20
- Pages
- 1305-1310
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2317610227
- Cited by
- 915
- References
- 0
- Citations by year
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- FWCI
- 46.75
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Agency for Healthcare Research and Quality (HS 07373)
- Topics
- Social Sciences › Gender Studies › Diversity and Career in Medicine
- Health Sciences › Health Professions › Emergency Medical Services › Global Health Workforce Issues
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- Black physicians, Hispanic physicians, racial and ethnic disparities in health care, underserved populations, physician shortage, primary care physicians, Medicaid, uninsured patients, socioeconomic status, affirmative action, physician practice location, California
- MeSH terms
- Workforce, Black or African American, California, Delivery of Health Care, Female, Hispanic or Latino, Humans, Insurance, Health, Male, Medically Underserved Area, Minority Groups, Physicians, Physicians, Family, Socioeconomic Factors, Multivariate Analysis
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