Factors Related to Physician Clinical Decision-Making for African-American and Hispanic Patients: a Qualitative Meta-Synthesis

• DOI: 10.1007/s40615-018-0468-z
• Publication Date: 2018-03-05T17:37:08Z
• Authors: Khadijah Breathett; Jacqueline Jones; Hillary D. Lum; Dawn Koonkongsatian; Christine D. Jones; Urvi Sanghvi; Lilian Hoffecker; Marylyn McEwen; Stacie L. Daugherty; Irene V. Blair; Elizabeth Calhoun; Esther de Groot; Nancy K. Sweitzer; Pamela N. Peterson
• Keywords: Physician-Patient Relations; Social Values; Minority health; Attitude of Health Personnel; Healthcare disparities; Communication; Clinical Decision-Making; Hispanic or Latino; 3. Good health; Black or African American; 03 medical and health sciences; Racism; 0302 clinical medicine; Bias; Humans; Minority Health; Healthcare Disparities; 10. No inequality; Clinical decision-making; Qualitative Research

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.