Physician Demographics, Kidney Patient Disparities Linked

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WASHINGTON—Significant disparities exist between the race of kidney disease patients and that of the physicians who will care for them, according to a study appearing online Jan. 27 in the Clinical Journal of the American Society Nephrology (CJASN).

The results suggest that efforts are needed to increase minority recruitment into kidney specialty programs to more closely balance the racial background of physicians and patients.

Kidney disease disproportionately affects African Americans: 32 percent of dialysis patients are African Americans, who make up only 13 percent of the U.S. population. Because having a physician who is the same race as the patient may help boost patient trust and improve care, increasing the number of African-American kidney specialists who practice in the United States might reduce or eliminate this health disparity.

To assess the racial concordance of physicians and patients, Mark Rosenberg, MD, Chavon Onumah, MD (Minneapolis Veterans Affairs Health Care System), and Paul Kimmel, MD (National Institute of Diabetes and Digestive and Kidney Diseases) examined recent trends in the racial background of U.S. medical school graduates, internal medicine residents, physicians in training to become kidney specialists, and patients with kidney failure or end-stage renal disease (ESRD).

The investigators found that while African Americans make up 32 percent of ESRD patients, they comprise only 6.5 percent to 7.1 percent of U.S. medical school graduates, 5.5 percent of internal medicine residents, and a mere 3.8 percent of all kidney specialist fellows. Also, only 3.3 percent of kidney specialists practicing in academic medical centers are African American. Importantly, patient disparities may worsen in the coming years because the number of ESRD patients is on the rise.

According to the authors, recruiting more African Americans into nephrology training programs may foster improved trust between ESRD caregivers and patients, increase access to care, alleviate ESRD healthcare disparities, and improve patient care.

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