Does Your Patient's Race Affect the Care That You Deliver?

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Do you treat your black patients differently than you do your white patients?

Few of us would be comfortable with this question. But a new study,^[1] published recently in the Archives of Internal Medicine, shows that some of us are treating our patients differently based on their race. The study, led by Dr. Thomas Sequist of Brigham and Women's Hospital in Boston, found some physicians are treating black diabetes patients differently than white diabetes patients, with the latter receiving higher quality care.

I was disappointed but not surprised by these results. Other research has shown that there is a racial and ethnic difference in healthcare. Researchers funded by the Agency for Healthcare Research and Quality have also found that blacks, Hispanics, and other minorities who go to hospital emergency departments in pain -- from serious conditions, like fractures and kidney stones -- are less likely than whites to receive narcotic pain medications.^[2]

The findings comport with 2 reports published earlier this year by AHRQ. Every year, we publish the National Healthcare Quality Report and National Healthcare Disparities Report, which continue to find gaps in the use of proven disease prevention and management strategies. Significantly, they quantify how racial and ethnic minorities and other vulnerable populations are receiving poorer quality care.

Overall, the quality of care provided by the US is improving, but improvements for minorities still lag. And we're still missing opportunities to help Americans avoid disease or serious complications.

We need to work together to eliminate disparities in healthcare. I commend the American Medical Association for its recent apology for discriminatory policies against black physicians.^[3] We need to work together to ensure care for all Americans is high-quality, evidence-based, patient-centered, effective, consistent, and equitable.

I'm Dr. Carolyn Clancy, Director of the US Agency for Healthcare Research and Quality, and that's my opinion.

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