I would like to begin this article with a question: Do the name and ethnicity of a doctor affect your decision when choosing a physician?
America has always been a melting pot with diverse cultures and ethnicity. The medical field is a melting pot in its own right with its own politics, conflicts, racial disparities and the like.
When I was starting medical school, my mother suggested that I should change my Chinese first name to an American one, which she reasoned would be easier for patients to remember. She thought that it would reveal my immigrant background, which may turn some patients away.
I immediately opposed this idea. There is no shame in being a physician with an immigrant background or a native name, I reasoned, and I never regarded my Chinese first name as a roadblock to success. If anything, it shows ambition, individuality, courage and hard work. I like my name: it carries my identity and ancestral background. In addition, I want to work for underserved populations and immigrant communities where, if anything, an immigrant background may allow me to form more trusting relationships with my patients.
Would you change your foreign name? Is there actually a correlation between ethnicity concordance and quality of the physician-patient relationship?
Dr. Pauline Chen, author of the “Doctor and Patient” blog in the New York Times, describes in her article “When the Doctor Doesn’t Look Like You“ the injustice many physicians face when they practice in America due to their international medical degrees and accents. To defend foreign physicians, Chen cites a landmark study by the Foundation for Advancement of International Medical Education and Research in Philadelphia. It showed no correlation between physician ethnicity and patient outcome. Rather, what mattered was physicians’ experience and training. Consequently, you would conclude that objective factors like accents, names and ethnicity should not come into consideration when choosing a physician.
What about the perception of foreign physicians to the American general public? The fact that such a study was warranted implies the presence of prejudices against physicians of certain races by the general public.
As it turns out, across the general population, patients do have a longer-lasting and more harmonious relationship with physicians of the same race. They view their doctor appointments as more satisfactory and intimate, and their doctors as more caring and compassionate. Another study, however, offered a similar but slightly different conclusion. In addition to race, gender and ethnicity, they also included whether patients had insurance as a factor. What they found was a bit surprising: Caucasian patients with insurance are more likely to seek Caucasian physicians than those without insurance; African-American patients without insurance are more likely to seek African-American physicians than those with insurance.
Good news for non-Caucasian Americans and physicians, according to a longitudinal data analysis conducted by the AAMC: the percentage of physicians of racial and ethnic minorities has increased dramatically from 2002 to 2004. Asians and Hispanics are projected to be the fastest growing racial groups in the overall physician population, followed by African-Americans and Native Americans.
With increasing numbers of Hispanic and Asian immigrants coming to America, and the overall growth of the minority population, the American health care arena is becoming increasingly diverse. Such heterogeneity requires both physicians and patients to be culturally sensitive and open-minded to maximize the utility of the physician-patient relationship.
Qing Meng Zhang is a medical student who blogs at in_Training.
