Factors Related to Physician Clinical Decision-Making for African-American and Hispanic Patients: a Qualitative Meta-Synthesis
- 5 March 2018
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of Racial and Ethnic Health Disparities
- Vol. 5 (6), 1215-1229
- https://doi.org/10.1007/s40615-018-0468-z
Abstract
Clinical decision-making may have a role in racial and ethnic disparities in healthcare but has not been evaluated systematically. The purpose of this study was to synthesize qualitative studies that explore various aspects of how a patient’s African-American race or Hispanic ethnicity may factor into physician clinical decision-making. Using Ovid MEDLINE, Embase, and Cochrane Library, we identified 13 manuscripts that met inclusion criteria of usage of qualitative methods; addressed US physician clinical decision-making factors when caring for African-American, Hispanic, or Caucasian patients; and published between 2000 and 2017. We derived six fundamental themes that detail the role of patient race and ethnicity on physician decision-making, including importance of race, patient-level issues, system-level issues, bias and racism, patient values, and communication. In conclusion, a non-hierarchical system of intertwining themes influenced clinical decision-making among racial and ethnic minority patients. Future study should systematically intervene upon each theme in order to promote equitable clinical decision-making among diverse racial/ethnic patients.Keywords
Funding Information
- National Institutes of Health (L60 MD010857, K08HS024569)
- American Heart Association (16SFRN29640000, 16SFRN29640000)
- University of Colorado Denver
- University of Arizona
This publication has 52 references indexed in Scilit:
- Enhancing transparency in reporting the synthesis of qualitative research: ENTREQBMC Medical Research Methodology, 2012
- Association of Unconscious Race and Social Class Bias With Vignette-Based Clinical Assessments by Medical StudentsJAMA, 2011
- Is race medically relevant? A qualitative study of physicians' attitudes about the role of race in treatment decision-makingBMC Health Services Research, 2011
- The physician's professional role in end-of-life decision-making: Voices of racially and ethnically diverse physiciansPatient Education and Counseling, 2010
- Non-clinical influences on clinical decision-making: a major challenge to evidence-based practiceJournal of the Royal Society of Medicine, 2010
- Primary Care Physicians’ Attitudes Regarding Race-Based TherapiesJournal of General Internal Medicine, 2010
- Physicians’ Implicit and Explicit Attitudes About Race by MD Race, Ethnicity, and GenderJournal of Health Care for the Poor and Underserved, 2009
- Physicians' attitudes toward race, genetics, and clinical medicineGenetics in Medicine, 2009
- Healthcare Workplace Conversations on Race and the Perspectives of Physicians of African DescentJournal of General Internal Medicine, 2008
- Methods for the thematic synthesis of qualitative research in systematic reviewsBMC Medical Research Methodology, 2008