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Could diversifying physician workforce help with disparities in care?

With marked growth in minority and non-English-speaking populations in the past two decades, researchers set out to study disparities in access to care. The study, which was published online, analyzed data from 7,070 patients across the country who were included in a 2010 federal survey, the 2010 Medical Expenditure Panel Survey.

After reviewing the data, it became clear that Black, Hispanic, and Asian physicians care for the majority of minority and non-English-speaking patients in the United States (54% and 70%, respectively), a patient population that already has difficulty accessing medical care.

Other findings include:

  • Black, Asian, and Hispanic patients were 19-26 times more likely to be cared for by a minority physician of their same race.
  • Low-income patients were 1.5-2 times more likely to be cared for by Black, Hispanic, and Asian physicians.
  • Medicaid patients were 2-4 times more likely to be cared for by Black, Hispanic, and Asian physicians.
“Patients from disadvantaged groups have substantial problems accessing care,” said the lead author, Dr. Lyndonna Marrast, a physician at Cambridge Health Alliance. “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.” Currently, minority physicians (African-American and Hispanic) make up less than 15% of the workforce, despite making up more than 25% of the U.S. population.

With the Patient Protection and Affordable Care Act being rolled out across the country, insurance coverage for low-income, uninsured patients, many of whom are minorities, is expected to expand. “There is a lot of concern that there will not be enough physicians willing and able to care for them,” said Dr. Danny McCormick, the study’s senior author and associate professor of medicine at Harvard Medical School. “In order to increase the number of Black and Hispanic physicians, medical schools will need to more fully consider the physician workforce needs of the health care system as a whole in admissions decisions.”

“Our findings do not argue for strengthening the existing de facto segregation of medical care,” said Dr. Steffie Woolhandler, professor of public health at City University of New York, co-founder of Physicians for a National Health Program, and a study co-author. “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.”