Exploring the Provider Preferences of Multiracial Patients

Background: Patient–provider race concordance has been argued as one way to improve patient–provider communication, patient satisfaction, and even patient outcomes. However, much of this literature focuses on or assumes that both patients and providers identify with only one race. Objective: The purpose of this study was to understand multiracial patients’ preferences in choosing a health-care provider. Methods: We conducted 15 interviews and 3 focus groups. We performed a directed content analysis to understand participants’ expressed preferences. Results: Thirty-one participants shared their health-care preferences. Participants described proximity to their homes or work, convenience in terms of availability, and health insurance coverage as reasons for selecting a provider. The majority articulated preferences related to provider gender and race. However, participants noted key barriers to receiving care from their preferred providers. Conclusion: This study highlights the preferences for health-care providers and the factors influencing those preferences and decisions among multiracial individuals. Findings illustrate the need to increase health workforce diversity, especially among primary care providers. Findings also show the need for increased empathy and cultural sensitivity among health-care professionals.

Responding to Patients’ Provider Preferences

In today’s increasingly diverse world, patients will inevitably interact with physicians who are of very different racial, ethnic, religious, and/or geographical backgrounds from themselves. When a patient requests a physician of another race, religion, or gender, or one who speaks another language, the physician must take many factors into consideration when determining whether to accede to the request. These considerations include historical factors (e.g., bigotry vs. the potential benefits of race concordance), ethical considerations (e.g., autonomy, justice), patient factors (e.g., the patient’s decision-making capacity), and organizational factors (e.g., policies and procedures to respect both patients and providers). This chapter presents a general framework to help psychiatrists to make these sometimes difficult decisions. Case vignettes are provided and analyzed throughout the chapter.

Patient Preferences

This chapter describes the complex and sometimes contradictory nature of race and gender preferences among middle-class Black women. First, the author presents a case study of Tammy, a focus group respondent whose great-grandfather was involved in the Tuskegee Syphilis Study. Although her case illustrates underlying assumptions of the race concordance hypothesis (that Black patients want Black providers), her story also points to the persistence of structural discrimination and limits of using race concordance as a strategy to overcome it. Second, Tammy’s case is contrasted with women who complicated the underlying assumptions of the race concordance hypothesis by emphasizing the intersection of race, gender, and other identities (e.g., disability, age, sexual orientation) on the formulation of preferences and the futility of race concordance as a strategy to mitigate the effects of a rushed, impersonal, and neo-liberal healthcare environment.