Survey of Connecticut physicians shows disparities in health care

First Connecticut research to examine how physicians care for patients from diverse racial, cultural and ethnic backgrounds

Connecticut physicians believe they could be providing better care to patients of diverse racial, cultural and ethnic backgrounds if they had training that was more accessible, according to the results of a survey released today by the Connecticut State Medical Society. "Providing Medical Care to Diverse Populations" is one of the first studies of its kind to seek physician input in helping reduce disparities in health care. The statewide survey of Connecticut physicians from 17 specialties was conducted from April to July through a grant from the Connecticut Health Foundation.

The findings indicate gaps in physician education programs that highlight cultural competency:

• Fewer than 2 in 5 physicians received some kind of cultural diversity education in medical school or residency.
• 70% of physicians were not aware of educational programs in this area that are available to them today.
• Physicians working in small practices, the setting that describes more than 80% of Connecticut physicians, were less likely to have received training in cultural literacy. Those working in hospital or medical school settings were the most likely to have had formal training in cultural awareness.
• Physicians ages 55-64, and those whose practices were mostly White, gave themselves lower ratings for providing culturally appropriate care.
• Women physicians were significantly more likely to provide interpreter services and patient-education materials in other languages.

In addition, the physicians surveyed identified patients' health insurance status as the greatest barrier to referrals. Forty-three percent called it "a big problem."

"The results of our survey tell a sobering story about our ability to communicate with patients, which is the foundation of the physician-patient relationship," said Kathleen A. LaVorgna, MD, president of CSMS. "The good news is that we can have an immediate impact on this situation by providing the kind of cultural awareness education physicians want and need."

CSMS is developing materials to educate physicians and office staff, working closely with national organizations dedicated to this issue. It plans to provide patient outreach materials through patient rights groups. A recent state mandate requires cultural diversity training for medical license renewal; CSMS hopes to assist in developing the curriculum so the end result is valuable for physicians. Near the conclusion of the two-year grant, CSMS will survey physicians again to measure progress in improving cultural competency.

Robert Aseltine, PhD, professor in the Division of Behavioral Sciences and Community Health and Director of the Institute for Public Health Research at the University of Connecticut Health Center, contributed to the report.