Physicians' Perceptions of Race and Engagement in Race-Based Clinical Practice: a Mixed-Methods Systematic Review and...

Area of Science:

• Medical Sociology
• Health Disparities Research
• Physician Practice Patterns

Background:

• Race, a social construct, is often inaccurately used in clinical practice, potentially harming minoritized patients.
• This study investigates physicians' understanding and application of race in patient care, termed race-based care.
• It also examines physician characteristics linked to these practices.

Approach:

• A systematic literature review was conducted across PubMed, CINAHL, EMBASE, and Scopus.
• Qualitative, quantitative, and mixed-methods studies on US physicians' race perceptions and race-based care were included.
• The Mixed Methods Appraisal Tool assessed risk of bias; thematic analysis and narrative synthesis were employed.

Key Points:

• Nine studies revealed five themes: belief in biological race, using race to contextualize health, counseling based on race, justifications for race-based care, and concerns about its use.
• Physicians' beliefs about evidence and the appropriateness of race in research influenced their support for race-based practice.
• Older age was positively associated with race-based care in quantitative findings.

Conclusions:

• Physicians' perceptions of race in medicine are varied, with a notable belief in its biological basis.
• Support for race-based care is tied to perceived evidence and the role of race in medical research.
• Older physicians' increased use of race-based care may stem from generational differences and exposure to specific medical literature.