December 3, 2008

Health Care Disparities

Study finds that patients' race and ethnicity may affect their experience in doctor’s office

By Peter Bendix

The study indicates that Latino and black patients with commercial insurance are more likely to receive care in low-performing primary care physician practices. Photo: iStockphoto

The race or ethnicity of patients may influence whether they have a positive experience at the doctor’s office, according to a new study co-authored by two Tufts professors.

William Rogers, a research assistant professor in the department of psychiatry, and Dana Gelb Safran, an associate professor of medicine, co-authored the report with three collaborators from the University of Washington about disparities in health care. The study, published in the Journal of General Internal Medicine, tracked 1,588 patients in California to determine if the racial or ethnic background of patients correlated with their experiences visiting a physician.

The results of the study were stark. Asians and Pacific Islanders were more likely to report worse experiences relative to whites in the same primary-care practices, which is consistent with another recent study that also found that Asians and whites had different experiences with the same doctors.

The study also found that whites often went to different primary-care physician practices than Latinos, blacks and American Indian/Alaskan natives, and the minority groups reported worse experiences than whites. The study authors suggest that this could be because these minority groups, especially Latinos and blacks, tended to seek care at practices that face “time constraints for clinical interactions and long in-office wait times.”

The authors acknowledge some limitations in their study. The response rate to their survey was “modest, but comparable to other patient experience performance measurement efforts nationally.” Additionally, blacks and Latinos are more likely to use public health insurance, and this study only involved commercially insured patients.

While other work has been done before on this issue, this study breaks new ground, the authors say. It is the first to demonstrate how physicians influence disparities in patients’ experiences and indicates that commercially insured Latino and black patients are more likely to receive care in low-performing primary-care physician practices.

They conclude that “if reducing ethnic and racial disparities in patients’ experiences of primary care is a priority, initiatives might achieve the largest impact by focusing on low-performing practices with high concentrations of racial and ethnic minority patients.”

Peter Bendix, A08, is an editorial assistant in Tufts’ Office of Publications. He can be reached at

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