Primary Care

Race and ethnicity play an important role in patient satisfaction with primary care physicians

Asian patients rated the performance of their doctors significantly less favorably than did white patients in a new study evaluating differences in attitudes toward primary care physicians among patients of various ethnic and racial backgrounds. The study, which was conducted by researchers at the Kaiser Permanente Medical Care Program in Northern California and the University of California, San Francisco, was funded by the Agency for Healthcare Research and Quality (HS08269). It appears in the March issue of Medical Care.

The study included reports from 1,007 Asian patients, 836 black patients, 710 Hispanic patients, and 7,747 white patients who received care from a mix of general internists, internal medicine subspecialists, and family physicians at 13 Kaiser facilities. The patients, who were between the ages of 35 and 85, were asked to rate doctors on their technical competence, communication skills, overall accessibility, prevention, and health promotion activities and to rate their overall satisfaction with the care they received.

Among different Asian ethnic subgroups, Chinese and Filipino patients appeared less likely to be satisfied with their physicians, while Japanese patients were least likely to say they would recommend their doctors. Hispanic patients rated physicians' accessibility and technical skills less favorably than white patients. Black patients gave physicians' use of the latest technology and of psychosocial and lifestyle health promotion a higher rating than white patients.

According to the study's principal investigator, Joe V. Selby, M.D., of Kaiser Permanente, these findings may represent actual differences in quality of care or variations in patient perceptions, expectations, and/or questionnaire response styles. Dr. Selby and his colleagues conclude that more research is needed to assess in accurate and culturally appropriate ways whether health plans are meeting the needs of diverse patient populations.

Details are in "Racial and ethnic differences in a patient survey: Patients' values, ratings, and reports regarding physician primary care performance in a large health maintenance organization," in the March 2000 Medical Care 38(3), pages 300-310.

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