Patients Prefer Doctors of Same Race and Ethnicity, Study Finds

A new study is shedding light on how some patients rate doctors of the same race or ethnicity. 

Researchers at Penn Medicine in Philadelphia found patients who shared the same racial or ethnic backgrounds as their physicians were more likely to give them the maximum patient rating score. The results may suggest how racial and ethnic similarities can affect patient-physician interactions.

The study, published in JAMA Network Open, analyzed 17,589 Press Ganey Outpatient Medical Practice Surveys, which are patient reported questionnaires used by hospitals and medical practices across the country to improve patient care and help determine promotions for physicians. The participants weren’t overly diverse; 82% being white, 12.7% were Black, 3.3% were Asian, and 2.3% were Hispanic. Each survey participant was classified as an adult who went through outpatient visits for a variety of medical specialties within the University of Pennsylvania Health System.

The surveys were conducted between July 2014 and May 2017. Patients were asked to answer questions on six different topics: access, moving through the visit, nurse/assistant, care provider, personal issues, and overall assessment. Patients were directed to rate their experience in each category from one (very poor) to five (very good).

For the question “Likelihood of your recommending this care provider to others,” researchers found patients gave the maximum score to 87.6% of doctors who came from racially/ethnically concordant patient-physician pairs. Among physicians form discordant pairs, 82.1% received the maximum score.

It’s worth noting that no associations were found between gender concordance and physician ratings. 

Is Bias a Bad Thing?

Although these findings point to implicit biases, the study authors don’t believe their results are necessarily a bad thing for the future of patient-physician relationships.

“If we can understand what patients like and don't like about their interactions with their physicians, then we will be able to make more targeted improvements in healthcare delivery, which I see as a good thing,” the study’s corresponding author Junko Takeshita, MD, PhD, MSCE, an assistant professor of Dermatology and Epidemiology in the Perelman School of Medicine at the University of Pennsylvania, tells Verywell.

It remains unclear whether racial/ethnic concordance limits patients from getting the best care possible. Some research suggests racial/ethnic concordance can result in better health outcomes. For example, a study out of the University of Miami found that Black patients may have less pain and anxiety when treated by a physician of their own race. Yet there have been other reports that did not find conclusive evidence that showed a link between positive health outcomes and patient-provider race-concordance.

“The doctor-patient relationship is a complex one and it is important to try to understand all of the elements that contribute to the patient experience,” study senior author Deirdre Sawinski, MD, an associate professor of Renal-Electrolyte and Hypertension in the Perelman School of Medicine, tells Verywell.

More research in this area needs to be done to fully understand the effects this kind of racial interrelationship has on healthcare delivery and health outcomes. But from the standpoint of patient preference, some minority patients may find it more difficult to access a physician of their preferred race/ethnicity “due to a general lack of diversity among the physician workforce,” Takeshita says.

A 2019 Association of American Medical Colleges (AAMC) report stated most active physicians were White (56.2%) and male (64.1%). 

Rachel R. Hardeman, PhD, MPH, an associate professor at the University of Michigan School of Public Health, has done her own research that found physician-infant racial concordance keeps many Black infants from dying. She tells Verywell the Penn Medicine study offers an important opportunity to reexamine racial disparities in health care.

“I think that having racially concordant physicians mitigates some of this disadvantage that we know is baked into the healthcare system due to a deep history of structural racism,” Hardeman says. “Racism needs to be a foundational study for medical education. Medical education needs to center marginalized identities and voices. If medical doctors leave their programs without an understanding of systemic racism or the ability to provide equitable care to patients of diverse identities, then those doctors were failed by their universities and professors.”

Takeshita believes one of the reasons why these racial imbalances were found in her study may come from the fact that patients and doctors of the same race tend to communicate with each other better, like some prior studies have indicated.

“I don't think this means that trust, communication, and health care cannot be good between racially/ethnically discordant patient-physician pairs," Takeshita says. "But our data seems to suggest that there is something different that is occurring during concordant interactions that we need to better understand and make sure is happening among all patient-physician interactions."

To help chip away at these differences in patient experience ratings, Takeshita and her team suggest the following actions:

• Diversifying the physician workforce so physicians are more representative of their patient populations. 
•  Having all physicians undergo implicit bias training and learn to care for patients in a culturally mindful and appropriate way.
• Training physicians on how to effectively manage the biases that patients can come in with.