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1 Center for Primary Care, Prevention, and Clinical Partnerships, Agency for Healthcare Research and Quality, Rockville, Md
2 The Robert Graham Center: Policy Studies in Family Practice and Primary Care, Washington, DC
3 Department of Family and Community Medicine, University of California, San Francisco, Calif
4 Department of Family Medicine and Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, NC
CORRESPONDING AUTHOR: Frederick Chen, MD, MPH, Department of Family Medicine, Box 354982, University of Washington, Seattle, WA 98195, fchen{at}u.washington.edu
PURPOSE Few studies have attempted to link patients’ beliefs about racism in the health care system with how they use and experience health care.
METHODS Using telephone survey data from a national sample of 1,479 whites, 1,189 African Americans, and 983 Latinos, we explored patients’ beliefs about racism, their preferences for the race and ethnicity of their physician, and their satisfaction with that physician. A scale was developed to reflect patients’ beliefs about racism. Race-stratified analyses assessed associations between patients’ beliefs, racial preferences for physicians, choice of physician, and satisfaction with care.
RESULTS Among African Americans, stronger beliefs about racial discrimination in health care were associated with preferring an African American physician (P <.001). Whereas only 22% of African Americans preferred an African American physician, those who preferred a African American physician and had an African American physician were more likely to rate their physician as excellent than did African Americans who preferred a African American physician but had a non–African American physician (57% vs 20%, P <.001). Latinos with stronger beliefs about discrimination in health care were more likely to prefer a Latino physician (P <.001). One third of Latinos preferred a Latino physician. Though not statistically significant, those who preferred and had a Latino physician rated their physician higher than Latinos who preferred a Latino physician but had a non-Latino physician (40% vs 29%).
CONCLUSIONS Many African Americans and Latinos perceive racism in the health care system, and those who do are more likely to prefer a physician of their own race or ethnicity. African Americans who have preferences are more often satisfied with their care when their own physicians match their preferences.
Key Words: Delivery of health care • health services research • ethnic groups • minority groups • prejudice • patient satisfaction
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