Experiences affect African-Americans' choice of doctor

One in five black patients prefers to see a black physician, a new study said.

By Damon Adams, amednews staff. Sept. 8, 2003.

Black patients who have experienced unfair treatment from a physician or nurse, or whose family has, are more likely to prefer black health care professionals, according to a new study.

A University of Cincinnati researcher found that race preference for a doctor or nurse was not related to patients' knowledge of current racial disparities in care or historical mistreatments such as the Tuskegee syphilis experiments, in which researchers withheld treatment from about 400 black men to study how the disease progressed.

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Instead, personal experiences of discrimination in health care were associated with a preference for a same-race doctor or nurse.

"The research shows that unfair treatment of African-Americans isn't just in the past. It happens to people today and it affects how African-Americans think about health care," said Jennifer Malat, PhD, an assistant professor of sociology at the University of Cincinnati who presented her research in August to the American Sociological Assn. "A study like this one reminds people that African-Americans still feel that they're being treated unfairly."

Minority health care has come under closer scrutiny since a March 2002 Institute of Medicine report found that racial and ethnic minorities received lower quality health care than whites. For example, minorities were less likely to undergo bypass surgery and to receive kidney dialysis than were whites.

Dr. Malat examined data from a national telephone survey of 1,189 blacks conducted in 1999 by the Kaiser Family Foundation. One in five blacks stated a preference to be treated by a black doctor or nurse. About two-thirds of respondents had no stated preference.

66% of black patients surveyed did not pick their physicians on the basis of race.

Dr. Malat said 23.8% of blacks personally had experienced unfair treatment or someone in their family had. That group of patients was more than twice as likely to state a choice of a same-race doctor or nurse.

Randall W. Maxey, MD, PhD, a nephrologist in Los Angeles, said other factors play a role in patients' choices of physicians.

"Most people I know choose black doctors because they trust them and they believe that these physicians care for them. They're from the same community and they're comfortable with them," said Dr. Maxey, president of the National Medical Assn., which represents more than 25,000 African-American physicians.

Dr. Malat said her research shows that doctors need to realize that patients have concerns about discrimination in the exam room.

"We can't just blame history for feelings about health care today."