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?
As illuminated by this week’s reading, there are many ways in which physicians contribute to health care disparities. On way is in teaching trainees, propagating untrue information about race and disease or failing to provide appropriate education on health care disparities. Another possible mechanism is through implicit bias. Physicians often make assumptions about their patients based on race, culture, or socioeconomic status. This can affect how they diagnose and treat disease, contributing to disparities. As a surgery trainee, I am interested in disparities in access to operation. One interested way to evaluate the effect of individual physicians on disparities would be to look at race, gender, socioeconomic status, etc, of patients that they see in clinic compared to those that are actually operated on.
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?
Access to same language providers/high quality interpreting services
Language of educational materials
Location of tertiary care centers
Difficulty with access/appointment scheduling for primary and specialty care
I think all of these factors affect what sort of treatment patients with peripheral vascular disease receive, and therefore are relevant to my area of research. Accessing vascular (or any) specialty care can be extremely challenging, requiring not only persistence, but flexibility in scheduling, which many people of lower socioeconomic status may not have. Additionally, we saw in the article by Parker et al, that language can have a profound impact on compliance and disease management.