Minority and nonminority pediatricians' care of minority and poor children

Background: Although it has been established that minority physicians tend to see more minority and more poor or uninsured patients, pediatrics as a s pecialty has not been studied in this regard. Objective: To determine if minority pediatricians disproportionately provid e care to minority children and to poor and uninsured children, relative to nonminority pediatricians, while controlling for possible confounding vari ables (socioeconomic background, sex, use of non-English languages in pract ice, and subspecialty training). Methods: In 1996, a stratified random sample of 1044 pediatricians, half of whom were underrepresented minorities (URMs) (African, Native, and Mexican Americans, mainland Puerto Ricans, and other Hispanics) and half of whom w ere Asian or Pacific Islanders, commonwealth Puerto Ricans, and whites (non -URMs), were surveyed about personal, practice, and patient characteristics . Results: Multivariate analyses reveal that, independent of other variables, being a URM pediatrician is significantly (P=.001) and positively associat ed with caring for a greater proportion of minority and Medicaid-insured or uninsured patients. Underrepresented minority pediatricians saw 24 percent age points more minority patients and 13 percentage points more Medicaidins ured or uninsured patients than did non-URM pediatricians. Conclusions: Compared with what non-URM pediatricians report, URM pediatric ians report caring for significantly (P=.001) more minority and poor and un insured patients. Given the few pediatricians who are URM, non-URM pediatri cians should be adequately prepared to provide care for minority patients, as the proportion of minority children is high and will be increasing signi ficantly in the next several years. Most important, efforts to ensure a rac ially and ethnically diverse health care workforce should be greatly enhanc ed, as its diversity, and hence representativeness, will improve the health care system for all Americans.