Patients feel their doctors don’t take their personal lives into consideration when treating them. (Wavebreakmedia)
A recent survey talked to patients about how they feel about the care they receive
African Americans and Latinos in this country are less likely than white folks to believe their doctors care about them, according to a recent survey.
“That’s one of the biggest takeaways of this work,” said Abigail Sewell, a postdoctoral research fellow in the University of Pennsylvania’s Population Studies Center and lead author of the study. “African Americans and Latinos are more likely to think this, though the latter group, the research shows, has an even deeper mistrust of physicians, likely because one or both Latino parents originally came from somewhere else. It reflects the relationship between immigrants and the health-care system. Most people who are immigrants or have some immigrant connection feel more disenfranchised from the health-care system.”
The survey, of 2,800 Americans 18 and older who do not live in institutional settings like jails or mental asylums, was culled by Sewell from the General Social Surveys conducted by the National Opinion Research Center. Interviewers went door to door asking for volunteers. About seven out of every 10 people agreed to the hour-and-a-half interview to determine what role a person’s race plays in his or her experience visiting a doctor.
“What we have are perceptual data: what patients feel when they go to a doctor. Minorities in general don’t have a lot of faith that they’re receiving the best care they could,” she said. “Number two, and I think more important, the fact that they think their doctors don’t care means they feel their doctors aren’t taking into consideration their personal lives.”
Sewell gave an example of an older woman whose doctor tells her she can’t lift more than five pounds for the next two weeks. But the woman cares for her 18-month-old grandchild, who weighs 20 pounds. “Doctors are trained to see symptoms,” she said. “They’re trained to follow a set of recommended behavior.” But to patients of a particular background, this can come across as a physician ignoring anything else. This, Sewell said, is called structural competency.
“This captures where people live. Not just where they live as far as place, but the where and the how,” she said. “They may live in poverty or have two jobs or live with three generations. They may still be working at age 65.”
Physicians paying attention to structural competency, a movement that’s slowly gaining traction, goes beyond simply looking at people’s culture, taking into account their neighborhoods, the institutions they care about and the policies that affect them.
“The very likelihood of being sick is actually shaped by the world that we live in, not just the biological processes,” Sewell said. “Structural competency aims to develop a language at a level above the patient.”
The next phase of Sewell’s research will examine at how patients use social media and other technology to better process health information. The current findings, funded by fellowships from the National Science Foundation, the Ford Foundation and Indiana University, appear in the journal Social Science Research.