Racial and Ethnic Minority Primary Care Providers: Improving Access and Patient-Provider Communication

Objective: To examine the role of Black, Asian, and Hispanic providers in the delivery of primary care to disadvantaged populations and to compare patient-provider communication by primary care provider race and ethnicity.

Study Design: Data come form the Medical Expenditure Panel Survey, a nationally representative survey of the U.S. noninstitutionalized civilian population. In this survey, individuals who identify a usual primary care provider are asked to report the gender, race, and ethnicity of that provider. In this analysis, patients who report Non-Hispanic White, Non-Hispanic Black, Non-Hispanic Asian, and Hispanic primary care providers are compared. Patient-provider communication is measured among individuals who visited their provider in the past year using standard CAHPS questions: how often their provider listened carefully, explained things, showed respect for what they had to say, and spent enough time with them.

Findings: Over half of Black, Asian, and Hispanic individuals identify a racial and ethnic minority provider as their usual source of primary care. Individuals who are uninsured, have family incomes below the poverty level, did not finish high school, and report poor health also disproportionately rely upon minority providers for primary care.

Patient-provider communication varies by primary care provider race and ethnicity. Individuals with Asian primary care providers are less likely to report that their provider always listens carefully, explains things, and shows respect for what they have to say; this may be explained in part by the concentration of Asian patients, who report more communication problems overall, among Asian providers. Better communication was generally reported when patient and provider race and ethnicity matched; communication problems were more common among White patients with Black or Asian providers, Black patients with Hispanic providers, Asian patients with Asian providers, and Hispanic patients with White providers.

Conclusions: Racial and ethnic minority primary care providers play a significant role in ensuring health care access and delivery to disadvantaged populations; minority primary care physicians treat a disproportionately unhealthier, poorer, less educated and uninsured patient population. In addition, patients with primary care providers of the same race and ethnicity may experience improved communication.