Lead author Darrell J. Gaskin, Ph.D., deputy director of the Hopkins Center for Health Disparities Solutions at Johns Hopkins Bloomberg School of Public Health explained:
"What this says to us is that we really need to encourage physicians to locate in these areas."
According to research, minorities, the poor and those living in inner cities and rural areas, as well as those who are uninsured are more likely to have an irregular source of medical care, compared with those who do not.
Gaskin explained that primary-care physicians are vital as they are "our first line of defense in the health-care system. They deliver most of our preventive and routine services in terms of checkups and initial acute-care services and do the initial diagnosis to let patients know if they need a higher level of care."
In order to find out which zip codes in U.S. metropolitan areas - which can include rural neighborhoods - had a shortage of primary-care physicians, the team examined data from the U.S. Census and American Medical Association from 2000 and 2006. The researchers defined a shortage of primary-care physicians as 1 physician per 3,500+ people, or no physician at all.
The researchers found that blacks and Hispanics were more likely to live in areas with few or no primary-care physicians (25.6% and 24.3%, respectively) than whites or Asians (13.2% and 9.6% respectively). Although areas with primarily black or Hispanic residents were more likely to have a shortage of primary care physicians, the researchers found that the disparity disappeared for Hispanics after controlling for socioeconomic factors.
Results from the study indicated the availability of a primary care physician was positively linked with segregation of Asians, as well as certain groups of Hispanics. According to the team, foreign-trained doctors may help reduce shortages in Asian and some Hispanic neighborhoods, as they may be seeking places where patients speak their languages.
According to the researchers, the cost to financially sustain a practice in black neighborhoods may be a reason for the shortage and not racism and bigotry. They explain that in these neighborhoods, more black patients are uninsured or covered by Medicaid.
Stephen B. Thomas, Ph.D., director of the University of Maryland Center for Health Equity, explained:
"In many ways, it confirms that being black matters. You cannot make a living as a solo practitioner, particularly in primary care, if you're serving a population that lacks the ability to pay."
Gaskin explained that solutions to solving the shortages include expanding health insurance coverage to individuals without insurance, as well as increasing doctors' reimbursement from the government to practice in areas with shortages. In addition, he states that it can be an extremely expensive proposition for a physician to treat the poor who use Medicaid for medical expenses.
"You can't pay physicians less for a service under Medicaid and expect them to want to practice in that kind of area. We're talking about areas where doctors won't be able to practice because they just can't sustain themselves."
Written By Grace Rattue