July 21, 2010 What if an emergency room patient wants a different doctor than the one who reports to their examination room?
If the patient is a woman or a racial minority, emergency physicians are more likely to honor their request to see a doctor of their same gender, race or religious background.
The study led by the University of Michigan Health System, along with colleagues from the University of Rochester and University of Pennsylvania, showed Muslim patients were the most likely to have their request accommodated.
It may be that women and minorities are more likely to make a doctor request, but when patients ask, female physicians are more supportive than male physicians. The findings were published in the Journal of Emergency Medicine.
"Some patients prefer, and are more satisfied with, providers of the same gender, race, or faith," says lead author and Robert Wood Johnson Clinical Scholar Aasim I. Padela, M.D., an emergency physician at U-M. "This study is the first to look at the culture of accommodation in the emergency department."
One-third of the 176 physicians surveyed at the American College of Emergency Physicians Scientific Assembly felt patients perceive they get better care from racial matching.
Black patients tend to rate black providers higher in quality and Hispanics are more satisfied with care received from Hispanic providers. Similarly a large percentage of Asians seek care from providers of a similar background.
The reason patients make the request is more complex than doctors may think, authors say. Prior discrimination, feelings of a lack of cultural sensitivity and language difficulties play a role in some patients preferring providers of similar backgrounds.
But according to the survey, physicians appear unaware of these patient experiences. The lack of awareness could affect physicians' attitude toward honoring patient requests and strategies to improve workforce diversity, authors say. Roughly 80 percent of emergency physicians in the United States are white.
Greater diversity among physicians is a much cited solution for addressing racial health disparities considering physicians and patients who share common values and language are more likely to develop stable health care relationships. Whether patients have better health outcomes needs further study, authors say.
"Within health care, and particularly within the emergency department, provider and patient matching is not entirely possible, nor in line with our value system," Padela says. "A better approach is to enhance cultural sensitivity and compassionate care."
Additional authors include Thomas Richardson, MBA, Ph.D., Sandra Schneider, M.D., and Hua He, of the University of Rochester Medical Center and Zarina Ali, M.D., of the University of Pennsylvania.
Funding was provided by the Department of Emergency Medicine at the University of Rochester Medical Center.
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