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APHA Scientific Session and Event Listing

Recorded presentation

Robin N. Cleeland, PhD, LCSW, Division of Social Work, Dalton State College, 650 College Drive, Dalton, GA 30720, 706-272-4562, rcleeland@daltonstate.edu

Disparities research has focused primarily upon identifying disparities and patient characteristics that are associated with disparities. However, physician characteristics that are associated with disparities in health care have been explored less frequently. Previous studies have explored the role of physician race, ethnicity, and gender and physician bias on disparities, but few studies have studied the effect of other physician characteristics. A review of the literature suggested that physician job satisfaction, decision-making style, social distance from the uninsured, and length of time in medical practice may be associated with variations in physicians' clinical recommendations.

This study explored relationships between job satisfaction, decision-making style, social distance from the uninsured, and time in practice and physicians' clinical recommendations. Survey instruments measuring social distance, job satisfaction, and tacit decision-making were mailed to a random sample of 250 Georgia family physicians. Recommendations for medical care were assessed using clinical vignettes that describe routine decisions encountered by primary care physicians in ambulatory settings. The data were analyzed using multiple regression analysis.

No relationship was found between the set of physician variables (job satisfaction, decision-making style, social distance, and time in practice) and decision outcome scores. In some clinical scenarios, the independent variables, decision-making style and time in practice, were associated with decision outcome, and time in practice was positively associated with job satisfaction. This study has important implications for health care policy in developing an effective response to the problem of medical indigence.

Learning Objectives:

• •List three potential determinants of disparities in medical care.
• •Identify the relationship between four physician characteristics and clinical recommendations for medical care by Georgia family physicians.
• •Discuss the implications of the findings of this study for health care policy.

Keywords: Access to Health Care, Physicians

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation