Shared demographics between patient, physician may improve outcomes in specialty care
Patient-physician concordance by age, sex, ethnicity, language, religion and socioeconomic status were as important in specialty care as in primary care and may improve clinical outcomes, according to published results.
To assess patient-perceived importance of patient-physician concordance, Romil F. Shah, MD, and colleagues from the department of orthopedic surgery at Stanford University asked two cohorts of patients to complete a survey on which physician characteristics they found important. The first cohort (patient cohort) consisted of 118 patients from a multispecialty orthopedic clinic, and the second cohort (volunteer cohort) consisted of 982 volunteer patients whom investigators recruited online using the Mechanical Turk platform [Amazon], according to the study.
After collecting patient demographic and socioeconomic characteristics, researchers asked patients to rate the importance of various physician characteristics on an ordinal scale of 1 to 10 for both a primary care provider (PCP) and specialty care provider. The characteristics included age, sex, ethnicity, national origin, sexual orientation, language, marital status, parental status, religion and personality, according to the study.
Researchers then performed paired T tests with a Bonferroni correction to quantify the differences in patient responses for PCP vs. specialist characteristics.
According to the survey results, the patient cohort showed no significant difference in importance of age, sexual orientation, ethnicity, national origin, language, marital status, parental status, personality and religion between PCP and specialist. However, the patient cohort did value concordance by sex less in specialists than in PCPs.
Additionally, the volunteer cohort showed no significant difference in importance of age, sex, sexual orientation, national origin, language, marital status, parental status, religion and personality between PCP and specialist. Yet, the volunteer cohort valued concordance by ethnicity less in specialists than in PCPs, according to the study.
Overall concordance scores showed that patients value age, national origin, language and personality in a specialty care provider equally as much as a they do in a PCP.
“Concordance between patients and physicians can lead to improved communication, adherence and health outcomes,” the researchers wrote in the study. “Only 6% of orthopedic surgeons are female, and only 13% of orthopedic surgeons are not white. It is possible that this lack of diversity hinders a patient’s ability to select a specialist with concordant traits. Continued efforts to increase diversity in orthopedic surgery, such as improving student exposure to subspecialties in medical school, are needed,” they concluded.
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