40% of docs say racial discrimination is present in healthcare

Four in 10 physicians in the United States agree that the nation's healthcare system treats people unfairly based on race or ethnicity, according to new data from the Commonwealth Fund.

This serves as a resounding blow to the nation's ongoing health equity efforts, as physicians in the U.S. are more likely to say that healthcare discrimination is a problem than their peers in the United Kingdom (25%) and Canada (26%).

The survey of primary care physicians in all three countries paints a picture of racial tension in America's healthcare settings.

In addition to the 40% of doctors who say the U.S. healthcare system treats people differently based on race, another half said they've heard as much from their patients. Specifically, 50% of physicians said their patients told them that they felt they were treated unfairly or that their healthcare concerns were not taken seriously because of their race or ethnicity.

That unfair treatment takes on numerous forms, the Commonwealth Fund noted.

For example, healthcare workers in the U.S., U.K. and Canada all noted that patients of color receive subpar care compared to that which white patients receive.

Specifically in the U.S., Black and Latino healthcare providers said healthcare discrimination affects clinical quality for patients of color. Patients of color are less likely to receive pain medication and experience long wait times in the emergency department (ED), survey respondents said.

Additionally, limited English proficiency and cultural competence contribute to healthcare discrimination in all three nations. Healthcare providers in the U.S. said speaking a language other than English adds to the different treatment racial and ethnic minorities sometimes receive.

Similar trends emerged in the U.K. and Canada, where healthcare providers stated that language barriers are the biggest contributors to discrimination outside of race or ethnicity. Importantly, language, race and ethnicity often intersect, provider respondents pointed out.

The Commonwealth Fund authors suggested that care delivery system reforms that deemphasize ED reliance will be key.

A total of 38% of U.S. physicians said they see racial health disparities in the ED, often due to the department's fast pace. When care decisions must be made quickly, bias is more likely to affect decision-making.

The U.S. healthcare system should reexamine equitable care access and investments into primary and preventive care that could reduce the need for ED care access.

Additionally, adopting universal health coverage could address discrimination in healthcare. Although racism is present in both the U.K.'s and Canada's healthcare systems, the issue is less pervasive. This is likely because patients in those countries have access to comprehensive payer coverage and do not necessarily need to seek ED care as often as their American counterparts.

But even with care delivery system redesign, the U.S. medical system will need to undergo an overall culture shift, the Commonwealth Fund authors said. Making it easy for staff and patients to report racism or discrimination and reviewing hospital policies for health equity will be key.

Supporting a more diverse medical workforce plus revamping cultural competence at the medical education level will also be important, the report authors concluded.

Sara Heath has covered news related to patient engagement and health equity since 2015.