Racial- and ethnic-minority patients are underrepresented in the outpatient practices of many medical and surgical specialties, according to a research letter published online July 19 in JAMA Internal Medicine.

Cristopher Cai, M.D., from Brigham and Women's Hospital/Harvard Medical School in Boston, and colleagues pooled data on adults from the 2015 to 2018 Medical Expenditure Panel Survey. Office and outpatient department visits to each of 29 physician specialties were examined, and adjusted rate ratios (ARRs) were calculated for each racial/ethnic-minority group versus the White population. Data were included for 132,423 individuals.

The researchers found that for most specialties, Black individuals had low visit rates compared with White individuals (23 of 29; 79.3 percent). Among specialties with many visits, Black:White disparities were particularly marked for dermatology, otolaryngology, plastic surgery, general surgery, orthopedics, urology, and pulmonology (ARRs, 0.27, 0.38, 0.41, 0.55, 0.59, 0.62, and 0.63, respectively). Visit rates to nephrologists and hematologists were higher for Black individuals (ARRs, 2.78 and 1.65, respectively), while visit rates were similar for internists, geriatricians, and oncologists. For Hispanic and Asian/Pacific Islander individuals, visit ratios were significantly lower compared with Whites for 20 of 29 and 21 of 27 specialties (69.0 and 74.1 percent, respectively); similar patterns were seen for Native American individuals.

"Black Americans die nearly five years younger than White Americans and are more likely to have chronic illnesses -- due to discrimination and poverty," Cai said in a statement. "Yet physicians who could close these gaps are far less likely to see Black patients."

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