MEDICAL MALPRACTICE
Minority health care clinics are prone to poorer patient outcomes, says study

A new study of minority health care clinics examines the influence of workplace conditions on health care disparities that can lead to medical malpractice situations.

February 10, 2009 – Minority Americans have poorer health outcomes from chronic conditions (such as hypertension, heart disease and diabetes) because clinics serving higher proportions of minority patients tend to have more challenging work environments, according to a study published yesterday in the Archives of Internal Medicine.

"Unfavorable patient and physician outcomes may be attributable to disparities in work conditions at these clinics," said Anita Varkey, MD, lead author, assistant professor in the department of medicine, Loyola University Chicago Stritch School of Medicine and medical director of general medicine at Loyola Outpatient Center, Loyola University Health System.

"When you have limited access to medical supplies, referral specialists, and examination rooms, coupled with a more complex patient mix, you can start to see the challenges involved with providing high-quality primary care," said Dr. Varkey.

The study compared 96 primary care clinics in five regions, including Chicago. Data were collected from 388 primary care physicians and 1,701 adult patients with chronic diseases. Researchers compared 27 clinics (41.8 percent of physicians) that had at least 30 percent minority patients with 69 clinics (45.9 percent of physicians) that had less than 30 percent.

The clinics with larger proportions of minority patients were four times more likely to have a chaotic work environment, and their physicians were half as likely to report job satisfaction. These physicians also had a tendency to report higher stress and intention to leave.

“All of these factors can contribute to health care disparities,” said Dr. Varkey, an internist who specializes in primary care, preventive medicine and women's health. “While further research is needed, health care reform strategies should consider the role that work environment plays in quality of care.”

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