Minority Clinics Tougher on Doctors
2009-Feb-09
By
-- Robert Preidt
MONDAY, Feb. 9 (HealthDay News) -- U.S. doctors in clinics that
serve primarily minority patients often face challenging workplace
conditions, which may affect patient care, a new study finds.
Researchers analyzed data from surveys of 96 clinic managers,
388 primary care doctors and more than 1,700 adult patients with
chronic diseases. Minority patients accounted for at least 30
percent of the patient base at 27 of the 96 clinics that took part
in the surveys conducted between 2001 and 2005.
"Physicians from 27 clinics with at least 30 percent minority
patients reported less access to medical supplies and to referral
specialists than physicians from other clinics," wrote Dr. Anita B.
Varkey, of Loyola University Medical Center in Maywood, Ill., and
colleagues. "These 27 clinics had poorer access to pharmacy
services, fewer patient examination rooms per physician and limited
written educational materials for patients with hypertension and
congestive heart failure."
The study also found that doctors at the 27 clinics were four
times more likely to report having a chaotic work environment and
half as likely to report having high job satisfaction, compared to
doctors at the other clinics.
Also, physicians at the 27 clinics were more likely to report
that their patients: speak little to no English (27.1 percent vs.
3.4 percent); have chronic pain (24.1 percent vs. 12.9 percent);
and involve cases that are medically (53.1 percent vs. 39.9
percent) and psychologically (44.9 percent vs. 28.2 percent)
complex.
Patients at the 27 clinics were also more frequently depressed
(22.8 percent vs. 12.1 percent), more often covered by Medicaid
(30.2 percent vs. 11.4 percent), and had lower health literacy (3.7
percent vs. 4.4 percent, on a scale where one is the lowest and
five is the highest).
The findings were published Feb. 9 in the journal
Archives of Internal Medicine.
"This study provides evidence of resource and workplace
organizational disparities between clinics that serve large numbers
of minority patients and clinics that do not," the study authors
wrote. "These deficiencies may contribute to physician stress and
time pressure, thereby complicating interactions with
disproportionately higher percentages of medically and
psychosocially complex patients. The combination of time pressure,
insufficient resources and complex patients likely constitutes a
'perfect storm' that contributes to the challenges that physicians
face in providing quality care to large proportions of minority
patients."
"National strategies to examine and intervene in health care
disparities should consider the work environment as a potential
determinant of disparities and as a target for interventions to
reduce physician burnout, increase work control and reduce clinic
chaos," the researchers concluded.
More information
The U.S. Centers for Disease Control and Prevention has more
about
minority
health.
HealthDay News
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