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Satel argues that the health care community has become enamored of a persistent but fallacious myth: that minorities receive inferior health care because of conscious or unconscious physician bias.
This “biased-doctor” model, as we call it, is a woeful misimpression of reality, but one that has become a staple of the “health disparities” campaign now underway at schools of medicine and in the American Medical Association, the Association of American Medical Schools, and health-care philanthropies.
To the extent that the drive against health disparities seeks to improve health of minorities — and there is no question that, as a group, they suffer worse health and receive poorer quality care than whites — its goal is worthy.
But effective solutions depend on an accurate understanding of the causes of race-related differences in treatment. And we have no evidence to support the idea that racially biased doctors are a cause of poor minority health — a proposition almost impossible to prove in any case.
Satel believes that access to care and quality of care are much more relevant factors in minority health outcomes than nebulous physician bias. She notes that researchers have found that, “on average”, white and black patients don’t even see the same groups of doctors. Poorer black patients are more likely to visit small group physicians who were “less likely to have passed a demanding certification exam in their specialty than the physicians treating white patients.” In short, socioeconomic status and geographic location seem to have more impact on patient care (irrespective of skin color) than lurking racism. These factors deserve to be studied and addressed but, like any doctor will tell you, finding the right cure first depends on making the right diagnosis.
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