by A new study conducted by Harvard T.H. Chan School of Public Health reveals that senior physicians may opt to see fewer Medicaid-insured patients and individuals from racial/ethnic minorities compared to their junior counterparts within the same medical practice. Lead author Michael Barnett, an associate professor of health policy and management, highlights that this unspoken practice in some clinics, where senior doctors delegate patients with lower-paying insurance and those from minority backgrounds to junior physicians, is rarely discussed openly. This study sheds light on this hidden practice, raising concerns about a two-tiered system that fosters racial and economic segregation based on physician seniority.
The research, titled “Differences by Physician Seniority in Race and Ethnicity and Insurance Coverage of Treated Patients,” was published in JAMA Network Open. The researchers analyzed data from 2017 claims provided by athenahealth and 2021 claims from Medicare, representing over 134 million patients and almost 200,000 physicians. They compared the patient populations treated by the most junior physicians with those treated by the most senior physicians within different practice types, such as cognitive (primary care or endocrinology), procedural (surgical or procedural specialties), and non-office-based (emergency medicine or radiology).
The study found noticeable disparities between the patient panels of senior and junior physicians in both cognitive and procedural specialties, based on insurance coverage and race/ethnicity. For instance, in the athenahealth data, senior cognitive physicians treated 1.6% fewer Medicaid patients and 1.2% fewer patients from racial/ethnic minorities compared to their junior counterparts. Similarly, senior procedural physicians treated 2.9% fewer Medicaid patients and 1.7% fewer patients from racial/ethnic minorities. These trends were also observed in the Medicare data, indicating that the findings were not specific to one data source. While the most significant differences were observed among procedural physicians, no significant disparities were observed among non-office-based physicians who do not conduct scheduled visits with patients.
The researchers suggest that other specialties may exercise discretion in assigning patients to specific doctors. They believe that cognitive and procedural specialists may be dissuaded from treating Medicaid-insured patients due to lower reimbursement rates or greater administrative burdens associated with such patients. Since Medicaid beneficiaries are more likely to belong to racial and ethnic minority groups, this preference could contribute to racial disparities in healthcare access. The researchers underscore that patient choice may also influence these disparities.
Barnett emphasizes that there is no clear evidence suggesting that senior physicians provide higher-quality care compared to junior physicians. However, based on his experience as a primary care physician, many patients prefer to consult with more experienced doctors. The study indicates that patients may face barriers in accessing physicians within the same practice, depending on their identity and insurance coverage. Addressing these obstacles and improving patient access to physicians from diverse backgrounds and expertise levels is vital for achieving a more equitable healthcare system.
*Note:
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
Money Singh is a seasoned content writer with over four years of experience in the market research sector. Her expertise spans various industries, including food and beverages, biotechnology, chemical and materials, defense and aerospace, consumer goods, etc.
