Racial and ethnic disparities in the perception of respect from physicians among skin cancer patients in the United States

Lauren M Fahmy; Celine M Schreidah; Larisa J Geskin

doi:10.1016/j.jdin.2023.01.009

Racial and ethnic disparities in the perception of respect from physicians among skin cancer patients in the United States

JAAD Int. 2023 Jan 27:11:78-82. doi: 10.1016/j.jdin.2023.01.009. eCollection 2023 Jun.

Authors

Lauren M Fahmy¹, Celine M Schreidah¹, Larisa J Geskin²

Affiliations

¹ Columbia University Vagelos College of Physicians and Surgeons, New York, New York.
² Department of Dermatology, Columbia University Irving Medical Center, New York, New York.

Abstract

Background: Racial and ethnic minority groups are at increased risk of poor skin cancer outcomes. Successful patient-physician communication is linked to better health outcomes, but it is unknown whether disparities in perceived care exist among skin cancer patients.

Objective: To investigate whether there are racial and ethnic disparities in the perception of physicians showing respect, listening, and explaining during clinical encounters.

Methods: A cross-sectional study was conducted using data from participants with a self-reported skin cancer history from the 2008 to 2017 and 2019 Medical Expenditure Panel Survey. Race and ethnicity were self-identified.

Results: Of 5570 participants, 5263 were non-Hispanic White and 307 were racial and ethnic minority individuals. Racial and ethnic minority participants were less likely to report that their doctors show them respect, listen to, and explain to them than non-Hispanic White participants, even when adjusting for age, sex, insurance type, health status, and survey year. Among racial and ethnic minority participants, perceptions of physicians listening and explaining were strongly associated with perceived respect.

Limitations: Lack of disaggregated racial and ethnic subgroup analysis.

Conclusions: Our findings suggest racial and ethnic disparities in perceived care among skin cancer patients. Future research is warranted to determine whether such perceptions contribute to disparities in skin cancer care and/or outcomes.

Keywords: CI, confidence interval; NHW, non-Hispanic White; NMSCs, non-melanoma skin cancers; aOR, adjusted odds ratio; basal cell carcinoma; distrust; ethnic disparities; explaining; listening; melanoma; mistrust; patient perception; patient-physician communication; patient-physician interaction; patient-physician relationship; racial and ethnic disparities; racial disparities; respect; skin cancer; squamous cell carcinoma.