Study Says Race Affects Patient Care

Black patients often get less aggressive care than Whites for heart attacks, even if they have Black doctors, a study found.

Experts have long noticed racial differences in medical treatment. Blacks often do not get the most up-to-date, high-tech treatments. But the reasons for this are unclear, and some have wondered whether physician bias might play a role.

However, a new study suggests that whatever the reasons, racism on the part of doctors is unlikely to be a major contributor.

Dr. Jersey Chen and others from Yale University analyzed Medicare data on more than 53,000 heart attack patients who were treated in 1994 and 1995 by 17,550 White and 588 Black physicians.

Whites were more likely than Blacks to receive diagnostic tests called angiograms, but the race of the doctor did not matter. If the doctor was Black, 38 percent of Black patients and 50 percent of White patients got these tests. If the doctor was White, 38 percent of Black patients and 46 percent of Whites got them.

The difference in testing seemed to have no effect on patients' outcome, though. Black patients' survival was as good as or better than that of Whites up to three years later.

The researchers speculated that Blacks may be less willing to take the risk of tests like angiograms, or Whites might demand them more adamantly.

An accompanying editorial by Drs. Arnold M. Epstein and John Z. Ayanian of Harvard said there is unlikely to be any single major cause of the racial disparities in health care, and eliminating them is "a complicated and difficult task.''

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