1) How do individual physicians contribute to health care disparities? Thinking about an area of health care of particular interest to you, what research do you think could be done to either understand the effect of individual physicians on health disparities, or to decrease this effect?
Physicians contribute to health care disparities due to implicit biases, prejudices, and stereotyping that they may be unconscious of. There is much evidence that supports this conclusion and that the bias is almost always pro-white. Black patients are routinely judged as being less likely to comply, less intelligent, and more likely to abuse drugs. In a general medicine practice, it may be helpful to teach physicians to be conscious of biases that they may have and metacognate. This way, physicians may be able to correct their biased behavior during a patient encounter. One way of making physicians conscious of their biases is to gather data on disparities in their individual practice, i.e. over-prescribing pain medication to whites, and showing it to them. Once the physician has accepted their erroneous behavior, interventions such as metacognition can be implemented.
2) Structural issues within health care delivery are implicated in health care disparities. Please brainstorm 4 structural issues that might contribute to these disparities. Which of these are relevant to your particular area of research, and how?
Insurance/financial: Those with fewer financial resources or lack health insurance are not able to access the same level of care as those who do, which disproportionately impacts minorities. This is due to the high cost of healthcare in the United States, which is simply unattainable for many people.
Geographical/transportation barriers: Many healthcare facilities such as hospitals, pharmacies, clinics, etc. are difficult to access for those in low SES communities due to lack of proximity, exacerbating disparities in healthcare. Furthermore, low SES individuals have fewer transportation options (either public or car), making it difficult to access healthcare in most settings.
Language/cultural/educational barriers: Healthcare institutions are based in English and usually require a certain degree of English proficiency and cultural understanding to navigate. Therefore, someone who is foreign, non-English speaking, and/or poorly educated will have difficulty accessing healthcare in the United States. This disproportionately affects low SES and minority populations.
Healthcare workforce: Given that the majority of healthcare workers are non-minorities, those in healthcare typically do not racially/ethnically resemble the communities in which they serve. This can create barriers to establishing trust and exacerbate the effects of physician biases.