Impact of Physician Practice Racial Composition on Patient Demographics

Background: Designing practices to better serve Black patients is necessary to decrease health disparities in America. Objective: To understand the impact of physician practice racial composition on patient demographics in a gynecology practice in the United States. We hypothesized that there will be an increased proportion of Black patients seen by all physicians within a practice by adding Black physicians to that practice. Design: This is a retrospective study comparing patient demographics of three subspecialty gynecology practices: Practice A, with two Black physicians added to the staff during the study period, and Practice B and C, without any Black physicians. Methods: We compared patient demographics by practice over time, including race (Black and White), insurance status (public vs private), and area deprivation index (ADI) as a proxy for socioeconomic status. Results: During the study period, there was a statistically significant increase in Black patients in practice A (slope = 0.0029; p < 0.001), while the proportion trend of Black patients decreased or remained flat in Practice B (slope = -0.0020; p = 0.027) and C (slope = -0.0010; p = 0.23), respectively. While Black physicians saw more Black patients than nonBlack physicians in Practice A, the proportion of Black patients seen by nonBlack physicians, though modest, steadily increased during the study period. Practice A saw patients with higher ADI and more patients with public insurance. Black physicians in practice A saw more publicly insured patients than nonBlack physicians. There was no difference in patients' ADI whether they were seen by Black or nonBlack physicians in Practice A. Conclusions: The addition of Black physicians to a practice is associated with increasing the proportion of Black patients seen by both Black and nonBlack physicians in that practice.