Martinez Kathryn A, Keenan Kaitlin, Rastogi Radhika, Roufael Joud, Fletcher Adrianne, Rood Mark N, Rothberg Michael B
Center for Value-Based Care Research, Cleveland Clinic, 9500 Euclid Ave, G10, Cleveland, OH, 44195, USA.
Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.
J Gen Intern Med. 2020 Sep;35(9):2600-2606. doi: 10.1007/s11606-020-06005-8. Epub 2020 Jul 6.
Patient satisfaction measures have important implications for physicians. Patient bias against non-White physicians may impact physician satisfaction ratings, but this has not been widely studied.
To assess differences in patient satisfaction by physician race/ethnicity.
A cross-sectional observational study.
Patients seeking care on a large nationwide direct to consumer telemedicine platform between July 2016 and July 2018 and their physicians.
Patient satisfaction was ascertained immediately following the encounter on scales of 1 to 5 stars and scored two ways: (1) top-box satisfaction (5 stars versus fewer) and (2) dissatisfaction (2 or fewer stars versus 3 or more). To approximate the information patients would use to make assumptions about physician race/ethnicity, four reviewers classified physicians into categories based on physician name and photo. These included White American, Black American, South Asian, Middle Eastern, Hispanic, and East Asian. Mixed effects logistic regression was used to assess differences in patient top-box satisfaction and patient dissatisfaction by physician race/ethnicity, controlling for patient characteristics, prescription receipt, physician specialty, and whether the physician trained in the USA versus internationally.
The sample included 119,016 encounters with 390 physicians. Sixty percent were White American, 14% South Asian, 7% Black American, 7% Hispanic, 6% Middle Eastern, and 6% East Asian. Encounters with South Asian physicians (aOR 0.70; 95% CI 0.54-0.91) and East Asian physicians (aOR 0.72; 95% CI 0.53-0.99) were significantly less likely than those with White American physicians to result in top-box satisfaction. Compared to encounters with White American physicians, those with Black American physicians (aOR 1.72; 95% CI 1.12-2.64), South Asian physicians (aOR 1.77; 95% CI 1.23-2.56), and East Asian physicians (aOR 2.10; 95% CI 1.38-3.20) were more likely to result in patient dissatisfaction.
In our study, patients reported lower satisfaction with some groups of non-White American physicians, which may have implications for their compensation, professional reputation, and job satisfaction.
患者满意度测评对医生具有重要意义。患者对非白人医生的偏见可能会影响医生的满意度评分，但这方面尚未得到广泛研究。
评估患者对不同种族/族裔医生的满意度差异。
一项横断面观察性研究。
2016年7月至2018年7月期间在一个大型全国性直接面向消费者的远程医疗平台上寻求治疗的患者及其医生。
在诊疗结束后立即通过1至5星的评分量表确定患者满意度，并采用两种方式计分：（1）顶级满意度（5星与少于5星）；（2）不满意（2星及以下与3星及以上）。为了近似患者用于对医生种族/族裔进行假设的信息，四名评审员根据医生的姓名和照片将医生分类。这些类别包括美国白人、美国黑人、南亚人、中东人、西班牙裔和东亚人。采用混合效应逻辑回归评估不同种族/族裔医生的患者顶级满意度和患者不满意情况的差异，同时控制患者特征、处方开具情况、医生专业以及医生是在美国还是在国际上接受培训。
该样本包括119,016次诊疗，涉及390名医生。其中60%是美国白人，14%是南亚人，7%是美国黑人，7%是西班牙裔，6%是中东人，6%是东亚人。与美国白人医生相比，与南亚医生（调整后比值比[aOR]为0.70；95%置信区间[CI]为0.54 - 0.91）和东亚医生（aOR为0.72；95% CI为0.53 - 0.99）的诊疗产生顶级满意度的可能性显著较低。与美国白人医生的诊疗相比，与美国黑人医生（aOR为1.72；95% CI为1.12 - 2.64）、南亚医生（aOR为1.77；95% CI为1.23 - 2.56）和东亚医生（aOR为2.10；95% CI为1.38 - 3.20）的诊疗更有可能导致患者不满意。
在我们的研究中，患者报告对某些非美国白人医生群体的满意度较低，这可能对他们的薪酬、职业声誉和工作满意度产生影响。
