Primary care physicians who treat blacks and whites Journal Article
| Authors: | Bach, P. B.; Pham, H. H.; Schrag, D.; Tate, R. C.; Hargraves, J. L. |
| Article Title: | Primary care physicians who treat blacks and whites |
| Abstract: | BACKGROUND: In the United States, black patients generally receive lower-quality health care than white patients. Black patients may receive their care from a subgroup of physicians whose qualifications or resources are inferior to those of the physicians who treat white patients. METHODS: We performed a cross-sectional analysis of 150,391 visits by black Medicare beneficiaries and white Medicare beneficiaries 65 years of age or older for medical "evaluation and management" who were seen by 4355 primary care physicians who participated in a biannual telephone survey, the 2000-2001 Community Tracking Study Physician Survey. RESULTS: Most visits by black patients were with a small group of physicians (80 percent of visits were accounted for by 22 percent of physicians) who provided only a small percentage of care to white patients. In a comparison of visits by white patients and black patients, we found that the physicians whom the black patients visited were less likely to be board certified (77.4 percent) than were the physicians visited by the white patients (86.1 percent, P=0.02) and also more likely to report that they were unable to provide high-quality care to all their patients (27.8 percent vs. 19.3 percent, P=0.005). The physicians treating black patients also reported facing greater difficulties in obtaining access for their patients to high-quality subspecialists, high-quality diagnostic imaging, and nonemergency admission to the hospital. CONCLUSIONS: Black patients and white patients are to a large extent treated by different physicians. The physicians treating black patients may be less well trained clinically and may have less access to important clinical resources than physicians treating white patients. Further research should be conducted to address the extent to which these differences may be responsible for disparities in health care. Copyright © 2004 Massachusetts Medical Society. |
| Keywords: | aged; major clinical study; review; united states; comparative study; statistics; diagnostic imaging; medical assessment; health care quality; health care; medicare; ambulatory care; hospital admission; cross-sectional study; cross-sectional studies; physician attitude; epidemiology; general practitioner; certification; european continental ancestry group; primary medical care; health care delivery; african american; quality of health care; patient referral; health care surveys; caucasian; race; negro; physicians, family; asian american; african continental ancestry group; asian; health services accessibility; office visits; asian americans; specialty boards; licence; humans; human; male; female; priority journal; article; empirical approach; health care and public health |
| Journal Title: | New England Journal of Medicine |
| Volume: | 351 |
| Issue: | 6 |
| ISSN: | 0028-4793 |
| Publisher: | Massachusetts Medical Society |
| Date Published: | 2004-08-05 |
| Start Page: | 575 |
| End Page: | 584 |
| Language: | English |
| DOI: | 10.1056/NEJMsa040609 |
| PROVIDER: | scopus |
| PUBMED: | 15295050 |
| DOI/URL: | |
| Notes: | New Engl. J. Med. -- Cited By (since 1996):496 -- Export Date: 16 June 2014 -- CODEN: NEJMA -- Source: Scopus |
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