A new study unearthed evidence that blacks trust physicians less than whites. The study, from the University of Pennsylvania, found nearly 45% of blacks have low trust levels, compared with 33.5% of whites.
The finding that there is a racial disparity in terms of practitioner trust doesn't surprise me at all. That's due, in part, to a recent discussion with my long-term pediatrician (who works at an acute care children's hospital) about treatment issues he sees. We talked about defensive medicine and lawsuits, but the part I found most intriguing was our discussion of racial disparities at the hospital. He told me that low-income black patients in the metro area just don't trust the doctors, particularly at the ER, and often give false phone numbers and addresses, which makes follow up impossible.
The UPenn study attributed much of the lack of trust to the fact that many blacks are uninsured and seek care in the ER, where the staff changes often. This makes perfect sense to me -- the experience of medical treatment chiefly through an ER setting, where you wait hours to see anyone, see a different doctor every time, and have an invasive, thorough medical history taken each visit, is quite different than visiting a consistent primary care doc.
What's interesting about the study as well is that the race of the physician didn't impact trust level, as one might expect it would. And that speaks to grave, structural trust problems between the African American population and medical practitioners.
Latino trust levels were not examined in this study. My pediatrician didn't believe that Latinos had as many issues with trust, but I wouldn't just take his word for it. Language barriers and fears of deportation create further hurdles for these families.
Many low-income patients continue to use the ER for care even when they have insurance (whether it's Medicaid or otherwise). The question for public health experts and medical practitioners, then, is to figure out how to decrease this utilization, which will lower health costs while building trust and more consistent care.