Minority docs likelier to care for poor patients
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Doctors of color may be bearing a disproportionate burden caring for patients most in need, with Black and Latino physicians far likelier to accept Medicaid than their white peers, new research shows.
Why it matters: The findings provide compelling evidence that race and ethnicity are directly connected to participation in the safety net program, and that diversity in the health care workforce is needed to address inequities.
- And they underscore how a small subset of primary care doctors may be caring for many of the poorest, sickest patients. In 2022, just 5% of active physicians identified themselves as Black and approximately 7% as Latino, Hispanic or of Spanish origin.
The big picture: Health care is deeply unequal when it comes to access, care delivery and outcomes.
- Despite efforts to expand access to care through Medicaid, which now covers almost 74 million people, beneficiaries can still face significant barriers finding a doctor.
- Doctors may be hesitant to accept Medicaid patients because of poor reimbursement rates, administrative hassles getting paid or a fear that they require more complex care, said Anushree Vichare, lead author of the study.
- This study focused on whether there are differences in practice patterns among those doctors who do accept Medicaid.
What they found: The George Washington University-led researchers found roughly half of family physicians had a significant number of Medicaid beneficiaries — what they defined as 150 or more — under their care.
- However, by linking unique data on physician race and ethnicity against 2016 Medicaid claims from more than 13,000 doctors, they found those who identified as Black had a 60% increase in the likelihood of accepting a significant number of Medicaid patients. Those who were Latino had a 40% increased likelihood.
- The study also found Black and Latino doctors tended to have higher overall numbers of Medicaid patients under their care than a reference group of white doctors.
- The study is limited to family physicians, who are generally more racially diverse than other physician disciplines.
Zoom in: The study supports calls for more diversity within the physician workforce, at a time when minority representation may lag further due to the recent Supreme Court decision on affirmative action.
- It also supports previous findings suggesting minority physicians are more likely to set up practice in communities of color that have traditionally had less access to health care and are more likely to suffer high rates of chronic conditions, researchers said.
- There have been a number of high-profile gifts in recent years to boost medical education among minorities, such as a $600 million commitment from Bloomberg Philanthropy in August to the endowments of four historically Black medical schools.
Yes, but: The paper is not suggesting "we want the minority clinicians to bear all the responsibility of working in underserved areas and caring for Medicaid patients," Vichare pointed out.
- "For clinicians, recruitment is the first step. It's a very critical step. But we also need to ensure that they're investing in retaining and growing and helping all clinicians thrive with fair and equal opportunities."
- "Investments in other workforce can be really critical, but at the same time, these investments should be across the professional continuum," Vichare said.
