Mar 21, 2024 - Health

Doctors less likely to respond to Black patients' emails, study suggests

Illustration of a large computer casting a shadow over a smaller computer.

Illustration: Aïda Amer/Axios

Black patients at large health systems may be less likely than white patients to get responses from doctors to emailed questions, a new JAMA Network Open study suggests.

Why it matters: Online patient portals, which allow patients easier access to their providers and grew in popularity during the pandemic, could be another example of how technology is furthering health care disparities.

What they found: Researchers examined responses to patient portal messages sent in 2021 from 39,000 primary care patients at Boston Medical Center, a large safety-net provider.

  • When looking at all provider types involved in patient care, such as registered nurses and physicians in training, there were similar response rates regardless of a patient's race.
  • However, there were differences in response rates from attending physicians, who oversee patient care.
  • That suggests health care providers may view messages from Black patients as a lower priority when triaging patient questions, the researchers wrote.

Zoom in: Just 21.1% of patients in the study sample were white, but they received 46.3% of responses from attending physicians.

  • Black patients were 3.95 percentage points less likely than white patients to receive a response from an attending physician, while they were about 3 points more likely to get a response from a registered nurse.
  • Hispanic and Asian patients were also less likely to receive a response from an attending physician (2.32 points and 2.11 points, respectively).

Between the lines: At the health system, patients' emailed questions are typically seen first by a triaging nurse, according to the study.

  • Researchers said the response rates may be due to those nurses forwarding fewer messages from minority patients along to doctors.
  • That could stem from differences in the types and content of messages or implicit bias, the researchers noted.
  • Boston Medical Center didn't respond to Axios' request for comment.

Reality check: The study examines patient messaging within just one academic health center, so the findings may not apply more broadly.

  • Future research should examine whether there's a difference in the value of responses from attending physicians and nurses, researchers said.
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