Experiences of ethnic minority primary care physicians with managed care: A national survey

Objectives: To determine if ethnic minority physicians experience more barr iers in acquiring and maintaining managed care contracts than white physici ans, and to determine if the physician's perceptions of his or her ability to provide appropriate care to patients varies with physician ethnicity. Study Design: Using a national sample, we identified 3 research areas germa ne to this topic and analyzed them by physician ethnic group. Methods: Analysis involved a pre-existing data set from a national survey t hat employed a random sampling approach to achieve reasonably accurate nati onal population estimates with acceptable margins of error (95% CI = +/-2). Results: A total of 1032 primary care physicians completed the survey (resp onse rate of 48%). After controlling for confounding variables, we found th at Asian physicians have the most difficulty keeping managed care contracts . Type of practice varies with physician ethnicity, and solo practitioners have more problems securing contracts than physicians in other types of pra ctices. Board-certified physicians are more likely to have managed care con tracts than those who are not. Latino physicians have significantly fewer m anaged care patients than primary cave physicians who are white, African Am erican, or Asian. The perceptions of the physicians of their ability to del iver appropriate care overall did not vary by ethnicity, but 2 major subcat egories of this item did vary by physician ethnicity: qualify of care, and limitations to providing care. Conclusions: Although we did not find overwhelming evidence of discriminati on against ethnic minority physicians, differences in rates of termination, type of practice, board certification rates, and managed care affiliation were related to physician ethnicity.