Racism is nothing new in American society, so it's hardly a surprise that it exists on some level in the U.S. healthcare system, black and Hispanic healthcare officials say.
The question is: How pervasive is racism against minority doctors in U.S. hospitals?
A study released earlier this month suggests that such discrimination is significant, affecting scores of minority physicians across the country who have a much tougher time than their white colleagues securing hospital admissions.
In fact, nearly one in three minority doctors reported that they could not obtain hospital admissions for their patients-higher than the estimated 25% rate among white physicians, according to the study by the Center for Studying Health System Change in Washington.
The study suggests a pattern of ethnic and racial disparities in America's healthcare system, said J. Lee Hargraves, one of three researchers who conducted the national survey for the center, a nonpartisan research organization funded by the Robert Wood Johnson Foundation.
"African-American and Hispanic physicians compared with their white colleagues have more difficulty getting needed services to their patients," Hargraves said. "The inability of minority physicians to obtain needed specialty and hospital care for patients likely contributes to the well-documented health disparities among African-Americans, Hispanics and whites."
Asked whether the disparity appears to be based on discrimination, Hargraves said, "When one looks at the large body of evidence about ethnic disparities in healthcare, you can't walk away without thinking that discrimination is one of the possible barriers to healthcare."
Based on a 1998-1999 survey of more than 12,000 physicians, the study is described by its authors as the first national report to examine the success of minority physicians in getting care for their patients. It was published in Medscape General Medicine, a peer-reviewed, online general medical journal.
"The data confirms what we've heard involving anecdotal information about the unfairness with which African-American and Hispanic physicians are treated," said B. Waine Kong, chief executive officer of the Association of Black Cardiologists, an Atlanta-based organization with about 800 members. "In fact, we're surprised that (the disparity) was that conservative. We thought it would be a lot worse."
Kong said one of the keys to reducing such discrimination is increasing the number of minority physicians. Only about 5% of U.S. physicians are Hispanic, and less than 5% are black.
"What's encouraging about this report is that it actually documents something that is very, very important," he said. "We want to make sure it motivates us to do better. We have far too few minorities (among the physician community). When you solve that problem, you put more (minorities) in a position of authority."
In an editorial accompanying the results, two Chicago physicians said the results support "anecdotal experiences" of minority physicians across the country.
"As African-American physicians who have lived and practiced in underserved communities for many years, we do not find the results from this surprising," wrote Cheryl Whitaker, M.D., and Eric Whitaker, M.D., of Northwestern University's Institute for Health Services and Policy Research, Chicago.
In an interview, Cheryl Whitaker, who is married to Eric Whitaker, said, "I think there is racism within the system. That may be hard to put your finger on, but these are some of the (statistics) that are measurable and do reflect some racism."
About 32% of black physicians in the study reported having trouble obtaining inpatient admissions, compared with 29% of Hispanics and 24% of whites.
"This adds to the story that minority patients are having worse access and more problems with outcomes," Hargraves said.
Minority physicians also were far more likely than whites to encounter roadblocks when seeking specialty referrals for their patients, the study found. About 12% of African-American and nearly 15% of Hispanic doctors reported such problems, compared with less than 8% of whites.
"These findings suggest there are real barriers in the healthcare system that keep minority physicians from being able to access needed care for their patients," Hargraves said.
The study suggests that disparities in health problems for minorities groups are exacerbated by these trends. For instance, deaths from heart disease are greater for blacks in the U.S. than for whites; and blacks and Hispanics are diagnosed with cancer at more advanced stages than whites.