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?
Answer: Individual physicians can contribute to healthcare disparities in any number of ways, including via implicit bias and statistical discrimination.
An area of healthcare that matters to me is student-athlete access to health and well-being resources. I'm not sure that research has been done to understand the effect of individual physicians and other care-providers on health disparities in this population, but I think it would be both helpful and interesting to do. I imagine that a possible research study could be having these care-providers take an implicit association test, or conducting an RCT, with the goal of identifying how this group treats black versus white patients (student-athletes). I imagine that the same implicit biases that exist in the larger healthcare sphere exist here, too.
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?
Answer: There are likely many structural issues within healthcare delivery that are implicated in healthcare disparities. The first that comes to mind is that the doctor sees and categorizes the patient's race before hearing symptoms and deciding how to deliver care (this likely triggers the "implicit bias" mechanism). Another is that a majority of care-providers are white, which is disproportionate compared with the number of minority patients, and likely affects what care the patients receive (again, perhaps because of implicit bias, or maybe even because of direct prejudice). To further aggravate the situation, I don't think that patients with a native language other than English are often matched with physicians who speak their language, or even an interpreter, which could mean that patients are agreeing (or not agreeing) to care that they should or should not receive (this was talked about a bit in the Brooks article). Finally, another possible structural issue could include public policies that make the healthcare system difficult to navigate for people without financial resources / education / first-hand knowledge of the system (I'm referring here to the "fragmented and challenging for all" aspect of our healthcare system).
I actually think that all of these mechanisms could be relevant to my area of research. For one, doctors also "see" race in my setting (the training room) before hearing a patient's symptoms. Further, there are very few minority caregivers in my setting, from what I recall. Beyond that, I don't know if there's any training on how to talk to foreign nationals or even translation services available. Finally, I think that the system IS challenging for all student-athletes, regardless of race, ethnicity, SES, etc. The NCAA has a lot to fix!