Physician Work Conditions Contribute To Challenges In Providing Quality Care To Minority Patients, Study Finds

Main Category: Primary Care / General Practice
Also Included In: Public Health
Article Date: 11 Feb 2009 - 5:00 PDT

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Physicians working in clinics with large numbers of minority patients face challenging work conditions, which likely contribute to disparities in care, according to a study released on Monday and published in the Archives of Internal Medicine, Reuters reports. For the study, researcher Anita Varkey of Loyola University Medical Center and colleagues looked at 96 clinics in New York City and in the upper Midwest that had one-third or more minority patients and compared them with those that had fewer minority patients. Patients in the study were being treated for high blood pressure, diabetes and congestive heart failure.

Researchers found clinics that serve more minority patients have a harder time getting medical supplies, referrals to specialists, pharmacy services and have less examination space. The physicians also reported having higher proportions of patients who were "difficult to serve -- non-English-speaking and medically and psychosocially complex," according to the study. Varkey said, "Physicians from clinics that serve larger proportions of minority patients reported more clinic chaos. The perception of chaos may be exacerbated by low levels of work control, high time pressure and complicated patients." Varkey said, "We can say that the challenges are measurably different from clinics serving lower proportions of minority patients."

She added that "time pressure, insufficient resources and patients with complex problems likely constitute a 'perfect storm' that contributes to the challenges that physicians face in providing quality care to large proportions of minority patients." Varkey said researchers did not determine the causes of the problems but geography and funding cannot be ruled out.

According to the study, clinic work environments should be improved to "reduce physician burnout, increase work control and reduce clinic chaos." Such "interventions may include better reimbursement for primary care and more widely available health insurance," they add (Conlon, Reuters, 2/9).

An abstract of the study is available online.

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