Black patients prefer black doctors

January W. Payne:

Several Web sites can help consumers find doctors and other health care providers with specified characteristics, including race, religion and sensitivity to sexual orientation.

The sites -- which list physicians who are African American, Christian or "gay- or lesbian-friendly" -- are putting a new spin on affinity-group marketing, a tactic usually associated with insurance or real estate sales.

"We feel that, with so many pressing medical issues for blacks, that we need to make sure that our medical issues are attended to," said Salli Purnell, marketing director for BlackDoctorFinder.com, a Web site based in Norfolk.

"If this can encourage more people to first go to the doctor [and] have the tests that they need done, then we've done something good," Purnell said. Seeing black doctors, she said, will make some people "feel more comfortable."

Some site operators said they created their services after studies showed that some patients relate better to physicians of the same race. A 2003 Johns Hopkins study found that "patient ratings of care and of doctors' efforts to get the patient to participate in decisions were higher when both the doctor and patient were African American or both were white than when the doctor and patient had different backgrounds," according to a summary of the study posted on the Web site of the Annals of Internal Medicine.

Other studies have found that "African American patients who see African American doctors report more involvement in medical decisions, higher trust and higher satisfaction with their doctors than African American patients whose doctors are not African American," according to the summary. Such involvement is considered important because black Americans still receive poorer health care overall than white Americans, particularly in the areas of heart disease and stroke, despite efforts to reduce discrepancies.

Sites run by groups such as the Gay and Lesbian Medical Association, the Christian Medical & Dental Associations and the National Medical Association -- an organization of black doctors -- allow patients to search their listings for free. Providers who belong to these groups can also post a listing.

The commercial sites also feature free searches. Most allow providers to post basic information at no charge; some impose a fee for a more detailed listing. A few sites that offer free registrations of providers are supported by advertising and donations.

It's not hard to see the sites' appeal, said Arthur Levin, director of the Center for Medical Consumers, a consumer advocacy group based in New York. "I think it's understandable given concerns about cultural sensitivity [that] people may feel more comfortable with a doctor if they look like them or think like them."

But there should be more to a patient's decision, Levin said. "If you're just searching one characteristic, which only has to do with what they believe or who they are, I think that's not a very good way to choose a physician."

David Stevens, executive director of the Christian Medical & Dental Associations, said the site's database was created in response to calls from patients seeking "Christian" referrals. Users of the service, he said, want a physician who "deeply cares about them as an individual" and who shares "their same worldview on clinical issues." The database gets about 65,000 hits per month, he said.

The gay and lesbian group's search engine emphasizes the importance of finding a doctor with whom patients can feel comfortable discussing their sexual orientation, said Joel Ginsberg, executive director of the group. "Have you ever wished that you had a doctor, dentist, therapist or chiropractor who understood and was sensitive to the needs of gay, lesbian, bisexual, transgendered or intersex people?" asks the database's introductory page. "Being out to your health care providers is important to ensure that you receive proper health care." Among the care that may be tailored to a patient's sexual habits and preferences are testing for sexually transmitted diseases and screening and vaccinations against hepatitis.

But while the Web sites clearly label a doctor's stated affinities, they offer no help in verifying the practitioner's credentials or assessing quality of care -- other factors that Levin says should go into choosing a doctor. Here, the sites tell patients they're on their own.

Findablackdoctor.com, for instance, carries this disclaimer: "Users are warned to check and verify the credentials of any alleged health care provider before consenting to any and all courses of treatment. Materials found on the site are for reference purposes only and are not recommended or endorsed by the owners of findablackdoctor.com. "More doctors, meanwhile, are taking note of the sites. Jacques Conaway, medical director of the sleep centers at Franklin Square Hospital Center and Harbor Hospital in Baltimore, explained his registration two months ago on findablackdoctor.com this way: "I realize that an increasing number of my patients are Internet-savvy, and whenever I have the opportunity, I like to leave a fingerprint out there" online, he said. "I certainly have a population of patients that really prefer having an African American physician. . . . I think that sitting down with someone who has shared cultural experiences makes the entire history and physical process easier and smoother for the patient."

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