STYLETHREAD -- LET'S TALK SHOP!

relrel · Marc Jacobs

Race and Gender Matching for Physician/Patient Relationships

Kelly · Hermes

While I get that maybe research backs it up, it does give me the "heebie-jeebies," too. I don't know what I think. I mean, it feels wrong to me, but who am I to say that it's wrong if it's proven to help people?

But why not let people have a choice? While I go to a female gyno, it'd feel weird for someone to tell me that I wasn't allowed to see a man for that purpose.

AllieGurl · Marc Jacobs

I think all patients should be given the choice in what doctor they choose to see. If that means a woman is more comfortable going to a women doctor so be it. If a african american man wants to have an african american doctor, so be it.

I DONT however think that this should be a decision that is premade for people. To me that seems like a backtrack to a time where there was much more prejudice in the world.

atlgirl · Gucci

diagnosis and treat thier race-matched patients closer to recommended standards of care

IMO this is the strongest pro argument. There are certain diseases and problems that affect each race differently. For example, IIRC, blacks are more susceptible (not sure susceptible is the right word, maybe its that the black population has a higher incidence of?) to sickle-cell anemia than other races. Asians are more susceptible to other things. (I know I'm being really general about this but it's early and I'm not quite awake yet). So it would make sense to me that a black or an Asian doctor might be more aware of this and be more on top of screening or treating or referrals, if necessary. Same with a woman ob/gyn. Men and women are taught the same thing, yes - but a woman doctor who's going (or has gone) through menopause might have a better personal understanding of what a female patient faces (or is going through) than a man does, even if he's "learned all about it in med school".

That said, I agree that everyone should be able to choose their doctor and not be "assigned" only to a certain race or gender of physician.

My own primary care is a man. And he's wonderful - I cringe to think about him ever retiring. He treats me fairly regularly for a chronic illness, so he knows my history and no matter how busy the practice is (and it's busy!), he always takes the time to answer all my questions and treat me (IMO) appropriately for my needs and my condition's needs.

I started out seeing his wife, but DH had to go to the doctor and they put him in with her husband...and he came back from the appointment absolutely raving about the visit. DH *never* raves about anything, so I paid attention. And when my Dr. was busy one time, they scheduled me with her husband. And I've never gone back to seeing his wife. Dr. Stuart is much more engaging, involved, and easy to talk to than his wife ever was.

However, my ob/gyn is a woman. And I wouldn't have that any other way.

If I was needing a specialist, though, for a surgical procedure or something specific, that changes things. At that level of care, someone who's done the specific procedure / treatment over the years would matter to me more than their race or gender. I'd want the best available.

squishy · Coach

relrel wrote:
1. spend more time with thier race-matched patients, 2. treat/see more uninsured and Medicaid populations, 3. diagnosis and treat thier race-matched patients closer to recommended standards of care.

i'm curious - how did they gather data for these studies? 1 and 2 seem to be pretty straightforward, but 3 eludes me.

i'm asking because i'm wondering if these studies really say more about the physician or the patients. are the physicians actually treating these same-race patients better? or are the patients actively seeking out same-race physicians and feel more content with their, for lack of a better word, service?

overall, i agree with the others: skill, knowledge and experience aside, whatever makes the patient most comfortable (whether it be gender, race, etc) is perhaps the next most important aspect of a physician.

relrel · Marc Jacobs

squishy wrote:

relrel wrote:
1. spend more time with thier race-matched patients, 2. treat/see more uninsured and Medicaid populations, 3. diagnosis and treat thier race-matched patients closer to recommended standards of care.
i'm curious - how did they gather data for these studies? 1 and 2 seem to be pretty straightforward, but 3 eludes me.

i'm asking because i'm wondering if these studies really say more about the physician or the patients. are the physicians actually treating these same-race patients better? or are the patients actively seeking out same-race physicians and feel more content with their, for lack of a better word, service?

overall, i agree with the others: skill, knowledge and experience aside, whatever makes the patient most comfortable (whether it be gender, race, etc) is perhaps the next most important aspect of a physician.

There's a couple different ways that this data has been collected (and there's been hundreds of studies that have looked at this issue so I'm sure I'm not covering every method):

1. Actual taped and filmed visits which are then analyzed using extremely clear-cut linguistical coding.
2. Analyzing disharge data, looking at DRG's (diagnose related groups- this is actually how Medicaid pays for healthcare) and Lengths of Stay.
3. Analyzing complete medical records comparing actual treatments and outcomes against recommended treatments and outcomes.
4. Interviews and surveys of both patients and physicians.

I guess I didn't explain myself well enough- it's not so much an issue of comfort or choice on the part of the patient but that there are better health outcomes when there is race concordance. No one is suggesting that race-matching will be a mandated thing or would even happen- simply that for whatever reason relationships in healthcare have better outcomes. One of the ways to acheive this is to increase minority scholarship funding.

I guess what my big problem is that on the one hand, I know deep in my heart that doctor's are people too and are just as fallable. But I have a hard time understanding that docs who get the same education can treat and diagnosis patients so differently. And when all the research seems to say is that the only difference seems to be race.

I guess in parts, I'm just a sad sad naive girl.

squishy · Coach

that... is unsettling. i'm sure i'm prejudiced, but it's startling to see that it affects people's ability to perform their daily duties.

relrel wrote:
I guess in parts, I'm just a sad sad naive girl.

don't lose that!!! as much as naivete is looked down upon, our society is severely lacking in it, and would benefit from some naive, idealistic (foolish) people.

LoMish · Kate Spade

I'm currently working on my masters in Womens Studies so we disucss issues of race and gender all the time! However, this has never come up in any of my classes so I am going to bring it up when we meet again and see what my classmates have to say. It is a very diverse group of students so I'm sure the opinions will range all over the board.
I do agree with what AllieGurl wrote though---the choice is what is important. When things start to be mandated is when we have a big problem!

AllieGurl wrote:

I think all patients should be given the choice in what doctor they choose to see. If that means a woman is more comfortable going to a women doctor so be it. If a african american man wants to have an african american doctor, so be it.

I DONT however think that this should be a decision that is premade for people. To me that seems like a backtrack to a time where there was much more prejudice in the world.

-- Edited by LoMish at 12:25, 2007-03-14