Does your primary care doctor have the same racial or ethnic background as you do? Research conducted by Dr. Lydonna Marrast, M.D. of Harvard Medical School and colleagues from the University of New York School of Public Health found that minority physicians serve the majority of minority patients in the United States.
The Growth of Minority Patient Populations
The study questioned 7070 adults from the 2010 Medical Expenditure Panel Survey. According to Dr. Marrast, 53.7% of minorities reported being served by minority physicians. 70.4% of non-English speakers reported having minority physicians.
Marrast notes that minority populations are expected to increase until racial and ethnic minorities may become the majority by the year 2050. Additonally, efforts to expand affordable medical care is likely to increase the number of previously underserved seeking health care. In a letter to the Journal of the American Medical Association, Marrast and colleagues write that it is “worrisome that there has been little growth in the proportion of black and Hispanic physicians relative to their population size.”
The Need to Recruit Minority Physicians
In an exclusive interview with Decoded Science, we asked Marrast whether or not her goal was primarily recruiting more minorities, so that minority physicians could continue to serve growing minority populations.
Her response, “We hope that one day all physicians will be caring for all types of patients. Until that day, it’s imperative that we train physicians likely to care for disadvantaged patients. We salute physicians, of any race, who choose to serve disadvantaged patients. However, the data is clear that minority physicians are much more likely than non-minority physicians to make this choice.”
Cultural Training and Financial Incentives
Marrast notes in her interview that an “alternative approach is the promotion of cultural competence among all physicians.” Cultural competency courses are required in the state of California and are designed to increase sensitivity to cultural issues.
She also notes that the Affordable Care Act is expanding financial incentives, such as those afforded by the National Health Service Corps (NHSC) in the form of the “loan repayment program established to get more physicians to work in a health shortage areas.” Marrast points to a study which found that the cost of medical school may be a major deterrent to African-Americans seeking a medical degree. She points to work by Dr. Dugger of Columbia University’s Mailman School of Public Health whose 2013 study reported: “Black respondents had the highest likelihood of debt greater than $150,000″ when compared to Whites and Asians.”
Drawing on previous research, Marrsat notes four policy implications of her research:
(1) findings lend support to the benefits of race-conscious admissions criteria in medical education;
(2) the need to maintain and increase funding to Title VII and VIII of the Public Health Services Act (which supports workforce diversity efforts);
(3) the need for stronger primary education in low income and minority areas and
(4) the need to monitor the impact of the Affordable Care Act on underserved populations.
Cultural Competency and Non-Minority Doctors
Could cultural competency training be effective in bridging cultural divides between minority patients and non-minority physicians? Perhaps the problem implies a multi-pronged approach with both recruiting efforts, financial incentives and cultural training all in the mix to ensure a healthy tomorrow for everyone.