Minority Docs See DTC Ads as Way to Address "Race Gap"

African-American physicians regard direct-to-consumer advertising of prescription medicines as one way to educate minority patients about needed treatment and healthcare options, according to a survey conducted by the National Medical Association (NMA). Almost all of the 900 physicians answering the questionnaire reported that DTC advertising has prompted patients to ask questions, and one-third acknowledged that they feel additional pressure to justify their prescribing decisions. But almost half (48 percent) said that such promotion increased communications between physicians and patients.

The main issue for NMA members is to "get patients in the door so we can interact with them," explains Dr. Sharon Allison-Ottey, the NMA board member who conducted the survey. In fact, NMA is calling on industry for more advertising; it wants pharma companies to place more ads in traditionally African-American media and to create more "culturally diverse" advertising initiatives so that minorities can "receive the full benefits" of such promotional efforts.

Because DTC ads address diseases that can disproportionately affect African-Americans, comments NMA president Dr. Lucille Perez, those ads "may be a beneficial tool to decrease the rampant disparities in the health of the community." NMA's full survey report is in the April 2002 issue of the association's journal. NMA says it hopes to influence FDA policy on DTC advertising and that a board committee will monitor effects of DTC advertisements on the African-American community. Pfizer funded the NMA survey with an unrestricted grant.

Unequal Treatment

The NMA survey reflects a surge in analysis about unequal treatment of racial and ethnic minorities in the nation's healthcare system. A March report from the Institute of Medicine (IOM) describes a pervasive bias among healthcare providers that has reduced the quality of healthcare for minorities. The report, "Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care," found that insurance coverage, income, age, and severity of condition fail to account for the disparities in care between white and minority groups. Instead, persistent discrimination and stereotyping, even by well intentioned providers, results in unequal care. Minorities, consequently, are less likely to receive necessary cardiac medications, to undergo bypass surgery, or to receive appropriate cancer treatments, kidney dialysis, or transplants. The report calls for educating minority patients about how to deal with the system to obtain needed care. Another proposal is to educate and train more minority physicians. Language disparities could be reduced by providing interpreters at clinics and health plan offices.

More Evidence

Another report from the Commonwealth Fund similarly found that minority Americans lag behind white patients on almost every measure of healthcare quality and are more likely to have communication problems with their doctors. Conversely, a Kaiser Family Foundation survey of physicians shows that most doctors refuse to believe that the healthcare system discriminates based on race, income, or educational status. Black physicians disagree; 80 percent said patients received unfair patient treatment based on race or ethnicity.

That view is examined in An American Health Care Dilemma, a book by two Harvard physicians that examines the hurdles faced by African Americans trying to enter medical schools and practice medicine. It describes the nation's alternative "subsystem" of healthcare for blacks that has reportedly been in place since colonial times.