Cardinal Health, Dublin, OH
Alexandrina Balanean, Yolaine Jeune-Smith, Bruce A. Feinberg, Ajeet Gajra
Background: Oncologists interacting with PCEM may be unaware of RA/IB, yet data show lower-quality care. Helping oncologists recognize this may improve quality of patient-provider interaction, care, and outcomes. We conducted a descriptive study of medical/hematologic oncologists to assess perceptions of RA/IB impact on PCEM interaction. Methods: From February to April 2021, U.S.-based medical/hematologic oncologists participated in an online survey of perceptions on cancer care and outcomes in PCEM (part of broader survey of various clinical and practice-related concerns). Questions used a modified 5-point Likert scale with an option of declining to answer, and respondents were aware data would be anonymized and aggregated. Results: Among 369 physicians surveyed, median years in practice were 17 (range 2-49). Most (72.4%) were in community settings; 64.0% were age 40 to 59 years; 20.6% identified as female, 70.5% male, and 8.7% declined to disclose. Racial distribution was 32.0% White, 33.1% Asian, 7.0% Black, 4.1% Hispanic/Latinx, and 18.7% declined to disclose. When asked the degree of RA/IB White providers had toward PCEM, 39.6% chose low/none, 33.3% moderate, 14.9% high/very high, and 12.2% declined. When asked whether RA/IB among White providers adversely affects PCEM, 37.1% somewhat/strongly agreed, 29.3% somewhat/strongly disagreed, 23.6% neither agreed nor disagreed, and 10.0% declined. Also, 7.9% declined to estimate percent of non-White patients managed. Perceived frequency of scenarios involving RA/IB impacting PCEM interaction at their practices was also assessed (Table). Notably, 12.0% to 14.0% declined to answer regarding their own practices. Although most oncologists (76.4%) perceived RA/IB among White providers toward PCEM, only 37.1% agreed it had adverse effects. Conclusions: Discrepancy in perception of RA/IB among White providers and its effect on PCEM suggests a need to show causality, and declining to respond suggests mistrust/apprehension in expressing true views. Findings suggest oncologists may benefit from improved education and awareness regarding RA/IB in PCEM interaction, treatment, and outcomes. Provider responses (N=369).
Decreased effectiveness of | Very often/Almost always, Often, or Sometimes (%) | Rarely/Never (%) | Decline to answer (%) |
---|---|---|---|
patient communication due to: | |||
· PCEM anxiety of discrimination, hostile/dismissive treatment by White provider | 48.0 | 40.4 | 11.7 |
· White patient perceives non-White provider as less competent/ understanding | 49.3 | 38.8 | 11.9 |
provider communication/performance due to: | |||
· Non-White provider perceives White patient as hostile toward/dismissive of expertise, diverts attention from communication to vigilant self-monitoring | 38.8 | 47.2 | 14.1 |
· White provider anxiety of being perceived as racially biased, experiences of distrust/hostility in PCEM interaction | 41.7 | 45.8 | 12.5 |
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