Association of Racial/Ethnic and Gender Concordance Between Patients and Physicians With Patient Experience Ratings

Abstract

IMPORTANCEThe Press Ganey Outpatient Medical Practice Survey is used to measure the patient experience. An understanding of the patient-and physician-related determinants of the patient experience may help identify opportunities to improve health care delivery and physician ratings. OBJECTIVETo evaluate the associations between the patient experience as measured by scores on the Press Ganey survey and patient-physician racial/ethnic and gender concordance. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional analysis of Press Ganey surveys returnedfor outpatient visits within the University of Pennsylvania Health System between 2014 and 2017 was performed. Participants included adult patient and physician dyads for whom surveys were returned. Data analysis was performed from January to June 2019.EXPOSURES Patient-physician racial/ethnic and gender concordance. MAIN OUTCOMES AND MEASURESThe primary outcome was receipt of the maximum score for the "likelihood of your recommending this care provider to others" question in the Care Provider domain of the Press Ganey survey. Secondary outcomes included each of the remaining 9 questions in the Care Provider domain. Generalized estimating equations clustering on physicians with exchangeable intracluster correlations and cluster-robust standard errors were used to investigate associations between the outcomes and patient-physician racial/ethnic and gender concordance. RESULTSIn total, 117 589 surveys were evaluated, corresponding to 92 238 unique patients (mean [SD] age, 57.7 [15.6] years; 37 002 men [40.1%]; 75 307 White patients [81.6%]) and 747 unique physicians (mean [SD] age 45.5 [10.6] years; 472 men [63.2%]; 533 White physicians [71.4%]).

The Intersection of Rural Residence and Minority Race/Ethnicity in Cancer Disparities in the United States

“…Acceptability is influenced by both racial/ethnic minority populations’ expectations of, and reality with, experiencing discrimination in healthcare systems and their mistrust of healthcare providers as a result of historical unethical and criminal behaviors, such as unauthorized treatments and experiments performed on Black people, and present-day biases (e.g., pain perception) [ 64 , 65 , 66 ]. Acceptability may be facilitated by racial–ethnic concordance between patients and providers [ 67 ]. However, the closure of many Black medical schools in the 20th century may have reduced the number of Black physicians by ~35,000 roughly over the last century.…”

Racial and Ethnic Diversity Among Obstetrics and Gynecology, Surgical, and Nonsurgical Residents in the US From 2014 to 2019

“…5 As a diverse workforce is more likely to provide care for underserved populations and foster higher levels of trust, efforts to recruit and retain underrepresented individuals from racial/ethnic minority groups, such as Black, Hispanic, Native American or Alaskan Native, Native Hawaiian or Pacific Islander individuals, within OBGYN are critical as we strive to close gaps in health disparities. 2 , 6 …”

“…1 While addressing these disparities requires multiple strategies, one approach is to increase diversity among health care practitioners, as patient-physician racial/ethnic concordance is associated with increased patient satisfaction and higher levels of trust. 2 Previous research, such as a 2020 study by Nieblas-Bedolla et al, 3 indicates that the OBGYN workforce includes more underrepresented physicians compared with other specialties. By examining current and recent trainees, we can assess recruitment efforts and estimate the future racial and ethnic diversity of the physician workforce.…”

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