Background: In the United States, there have been numerous studies showing health disparities and inequities in care related to race and gender; lack of gender and racial concordance between physicians and patients has been hypothesized as a partial explanation for such findings. Research has also suggested that patients prefer physicians who look like them; while female physicians are gaining on the male majority, there are far too few underrepresented minority physicians in the workforce. While studies have explored the impact of race and gender concordance on physician performance in the outpatient setting (where longitudinal care allows for relationships to flourish over time), none have done so in the inpatient setting with a tool designed specifically for hospitalists. In this study, we utilized a validated tool called TAISCH (Tool to Assess Inpatient Satisfaction with Care from Hospitalists) to assess the effect of patient-provider race and gender concordance on patient assessment of their physician’s care. TAISCH collects real-time patient satisfaction data that are wholly attributable to specific hospitalist providers.
Methods: Cross-sectional data was collected in 2012 and 2015 at a 560 bed, urban teaching-hospital. A total of 439 inpatients admitted to the non-teaching hospitalist service were surveyed using the 15 item TAISCH questionnaire. These patients were cared for by 40 unique hospitalist physicians. The TAISCH assessments were collected by a research assistant while the patient was still in the hospital and only if the patient was able to name and identify the hospitalist provider who had been caring for them for the last 2 or more consecutive days. Mean TAISCH scores were calculated; patients rate their physician across 15 questions all of which have 5-point Likert scale response options. Comparisons were made to assess the impact of gender and racial concordance across patient – hospitalist pairs. Generalized estimating equations were used to account for clustering or multiple observations attributable to each physician.
Results: Of the 40 hospitalist providers in the analysis, 8 (20%) were African American (AA), 8 (20%) were Caucasian, and 24 (60%) were of the Other Race category. Caucasian providers scored highest overall with a mean TAISCH score of 4.18 (SD = 0.5); AA physicians mean score was 3.87 (SD = 0.64), and hospitalists of other races mean score was 3.90 (SD = 0.67). The majority of the patients (66%) were Caucasians; 32% were AA and 2% of another race. There were no statistically significant differences noted between TAISCH scores of gender and racially concordant versus discordant patient-doctor pairs (both p’s >0.05).
Conclusions: This study’s findings suggest that hospitalized patients are equally satisfied with physicians who look like them with respect to race and gender as they are with those who are dissimilar to them. In the inpatient setting where patients truly have no control over the physician who will be assigned to oversee and coordinate their care, it appears as if physician race/gender does not affect patient assessment of physician performance.
To cite this abstract:Crawford, DD; Paranji, S; Chandra, S; Landis, R; Wright, S; Kisuule, F . ASSOCIATIONS BETWEEN HOSPITALISTS’ RACE/GENDER AND PATIENT ASSESSMENT OF PHYSICIAN PERFORMANCE. Abstract published at Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev. Abstract 55. Journal of Hospital Medicine. 2017; 12 (suppl 2). https://www.shmabstracts.com/abstract/associations-between-hospitalists-racegender-and-patient-assessment-of-physician-performance/. Accessed September 16, 2019.