The Patient-Provider Relationship Role in Health Equity

In the pursuit of health equity, patient-provider relationships and patient perceptions about their health professionals are vital in making improvements. Here’s a look at where things stand with some Black, Indigenous, and People of Color (BIPOC) and other marginalized groups and how progress can be made to remove barriers to equitable care.

Equitable Care Perceptions of Patients and Healthcare Providers

In a discussion paper by a panel of clinicians, a long list of factors that reduce equitable care includes race, ethnicity, socioeconomic status, incarceration status, English language skills, education, geographic location, age, citizenship status, insurance status, gender identity, sexual orientation, religious beliefs, health status, and more. Action must be taken to work toward equitable care for underserved groups, and survey questionnaires of patients can also help gauge patient perceptions and how they change over time.

Despite perceptions and perceived efforts by the healthcare professionals that serve them, approximately half of the BIPOC and other marginalized patients surveyed discontinued scheduling regular healthcare services. The reasons given for discontinuing their services included feeling their doctor couldn’t help them or simply didn’t feel understood by their doctor. In contrast, 90 percent of the healthcare professionals surveyed felt they tried to be sensitive to the feelings of their patients and to treat them as equals.

Taking a closer look specifically at Black, Latinx, LGBTQ+, and low-income patients, the survey showed a higher percentage of patients compared to the previous year who felt the healthcare system was fixed against them – at 54 percent this year compared to 52 percent last year. So even though the COVID-19 pandemic has been thought by many to bring more health equity through telemedicine options, this isn’t necessarily the case and may have gotten worse according to some studies.

Removing Barriers to Equitable Healthcare

With so many barriers to equitable care, action must be taken to improve patient outcomes. Pharma companies, patient advocacy groups, and others interested in improving health equity are looking at additional ways to improve access to healthcare. Some community-based places have emerged to connect patients with healthcare advocates and professionals. According to Genentech’s chief diversity officer, Quita Highsmith, “We’ve got to build coalitions and partnerships, and it can start in small personal interactions in community spaces—what I call the three Bs – the bishop, barbershop and beauty salon.”

With language serving as another barrier to equitable care, community-based places like the three Bs can help reach more people to ensure clear communication in their preferred language. Healthcare advocates can work to bring interpreters or healthcare professionals who speak other languages to meet underserved patients. 

Patient-provider communication is a vital piece of the healthcare patient experience. With some of the patients surveyed feeling they were unheard by their healthcare professionals, booking an appointment with a nurse practitioner might be an option worth trying. Some patients feel that nurse practitioners listen more closely in comparison to doctors and have a preference for seeing nurse practitioners as their primary healthcare professional 

Patient and family engaged care is another strategy viewed by some as an integral part of improving care for underserved patient groups. Visits with healthcare professionals can feel overwhelming to some patients. If patients can ask a family member or friend to go with them to in-person healthcare visits or to join telemedicine visits with them, they can help ask questions and to write down information from the healthcare professional. Trust between the patient and healthcare professional can also be built by including friends or family members. These family members and friends can also continue to ask the patient how they’re feeling and can write down any symptoms or treatment side effects for follow-up visits.

Patients, healthcare professionals, and patient advocates must continue to take action to improve health equity and access for all. Writing to your Congressperson to support healthcare for all, visiting patient advocacy websites, and volunteering as an interpreter if you speak another language are some ways to help. You can also email us at [email protected] to report healthcare discrimination and to seek guidance on connecting to actionable resources.

In retaining editorial control, the information produced by Diverse Health Hub does not encapsulate the views of our sponsors, contributors, or collaborators.

Importantly, this information is not a substitute for, nor does it replace professional medical advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a healthcare professional.

Sources

Natalie Missakian. Genentech Study Reveals Health Equity Perception Gap Between Patients and Doctors. Fierce Pharma website. Accessed October 5, 2021. https://www.fiercepharma.com/marketing/marginalized-groups-say-pandemic-made-unfair-health-care-system-worse-genentech-survey 

Melissa Simon, Cynthia Baur, Sara Guastello, Kalpana Ramiah, Janice Tufte, Kimberlydawn Wisdom, Michelle Johnston-Fleece, Anna Cupito, and Ayodola Anise. Patient and Family Engaged Care: An Essential Element of Health Equity. National Academy  of Medicine website. Accessed October 5, 2021. https://nam.edu/patient-and-family-engaged-care-an-essential-element-of-health-equity/