Minority Patients Mostly Treated by Nonwhite DoctorsNicole Ostrow
Doctors who are black, Hispanic and Asian provide the most care to minority patients, according to a study that suggests changes under Obamacare may increase the burden for these physicians.
More than half of minority patients and about 70 percent of non-English-speaking patients, groups more likely to have Medicaid or be uninsured, are cared for by a nonwhite doctor, according to a research letter today in JAMA Internal Medicine.
President Barack Obama’s 2010 Patient Protection and Affordable Care Act, the biggest overhaul of the U.S. health-care system since the 1960s, is expected to insure millions of Americans who previously couldn’t afford health coverage. Though blacks and Hispanics represent 25 percent of the U.S. population, they make up less than 15 percent of physicians, highlighting the need for medical schools to recruit more minority students, researchers said.
“When we think about our health-care system or just health in general, we need to make sure it’s meeting the needs of all members of society and it’s doing so in an equitable fashion,” said lead study author Lyndonna Marrast, a physician at Cambridge Health Alliance in Cambridge, Massachusetts, and a fellow in general medicine at Harvard Medical School. “The fact that minority physicians are much more likely to care for disadvantaged patients suggests that expanding the racial diversity of the physician workforce in the U.S. could be key to improving access to care.”
She said minority doctors may treat more minority patients because of a combination of many factors including where doctors choose to locate their offices as well as patients choosing physicians who are the same race.
The study looked at data from 7,070 adults in the 2010 Medical Expenditure Panel Survey, which identified medical providers.
They found patients who were on Medicaid were cared for by a black, Hispanic or Asian physician two times to almost four times more often than those not on the government program for the poor. Patients considered low income were more often treated by a minority physician than those with a high or middle income. And minority patients were more often cared for by a minority physician of their same race than non-Hispanic white patients, the authors said.
Also underlying the growing burden on nonwhite doctors is the growing minority population. A U.S. Census Bureau report in 2012 found the number of minority children under age 18 in the U.S. will surpass 38.2 million in 2019, outnumbering the 37.7 million white, non-Hispanic children about four years in advance of earlier predictions. Hispanics and Asians will remain the nation’s fastest growing minority groups, doubling by 2060.
“Our findings do not argue for strengthening the existing de facto segregation of medical care,” said Steffie Woolhandler, a professor of public health at City University of New York and a study author, in a statement. “But it is clear that doctors’ decisions on where to practice and patients’ decisions on where to go for care combine to create an outsized role for minority physicians in caring for the underserved.”