M. Van Ryn et J. Burke, The effect of patient race and socio-economic status on physicians' perceptions of patients, SOCIAL SC M, 50(6), 2000, pp. 813-828
Despite its potential influence on quality of care, there has been little r
esearch on the way physicians perceptions of and beliefs about patients are
affected by patient race or socio-economic status. The lack of research in
this area creates a critical gap in our understanding of how patients' dem
ographic characteristics influence encounter characteristics, diagnoses, tr
eatment recommendations, and outcomes. This study uses survey data to exami
ne the degree to which patient race and socio-economic status affected phys
icians' perceptions of patients during a post-angiogram encounter. A total
of 842 patient encounters were sampled, out of which 193 physicians provide
d data on 618 (73%) of the encounters sampled.
The results of analyses of the effect of patient race and SES on physician
perceptions of and attitude towards patients, controlling for patient age,
sex, race, frailty/sickness, depression, mastery, social assertiveness and
physician characteristics. are presented. These results supported the hypot
hesis that physicians' perceptions of patients were influenced by patients'
socio-demographic characteristics. Physicians tended to perceive African-A
mericans and members of low and middle SES groups more negatively on a numb
er of dimensions than they did Whites and upper SES patients. Patient race
was associated with physicians' assessment of patient intelligence, feeling
s of affiliation toward the patient, and beliefs about patient's likelihood
of risk behavior and adherence with medical advice; patient SES was associ
ated with physicians' perceptions of patients' personality, abilities, beha
vioral tendencies and role demands. Implications are discussed in terms of
further studies and potential interventions. (C) 2000 Elsevier Science Ltd.
All rights reserved.