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Affinity medicine

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  • Affinity medicine

    So there was an interesting article in the Post's Health Section today about increasing numbers of people choosing their physician based on race, religion or lifestyle. In the interest of debate, I usually go to a female nurse practitioner for my annual gyn exam. I have always been assigned NPs first both with the military and in my former civilian life. When I have had to select physicians, I usually pick a female first.

    Your Kind of Doctor
    Some Web Sites Help Patients Find Physicians of Their Race, Religion or Sexual Sensitivities. Credentials? Well . . . .
    By January W. Payne
    Washington Post Staff Writer
    Tuesday, January 31, 2006; Page HE01

    Several Web sites can help consumers find doctors and other health care providers with specified characteristics, including race, religion and sensitivity to sexual orientation.

    The sites -- which list physicians who are African American, Christian or "gay- or lesbian-friendly" -- are putting a new spin on affinity-group marketing, a tactic usually associated with insurance or real estate sales.

    "We feel that, with so many pressing medical issues for blacks, that we need to make sure that our medical issues are attended to," said Salli Purnell, marketing director for BlackDoctorFinder.com, a Web site based in Norfolk.

    "If this can encourage more people to first go to the doctor [and] have the tests that they need done, then we've done something good," Purnell said. Seeing black doctors, she said, will make some people "feel more comfortable."

    Some site operators said they created their services after studies showed that some patients relate better to physicians of the same race. A 2003 Johns Hopkins study found that "patient ratings of care and of doctors' efforts to get the patient to participate in decisions were higher when both the doctor and patient were African American or both were white than when the doctor and patient had different backgrounds," according to a summary of the study posted on the Web site of the Annals of Internal Medicine.

    Other studies have found that "African American patients who see African American doctors report more involvement in medical decisions, higher trust and higher satisfaction with their doctors than African American patients whose doctors are not African American," according to the summary. Such involvement is considered important because black Americans still receive poorer health care overall than white Americans, particularly in the areas of heart disease and stroke, despite efforts to reduce discrepancies.

    Sites run by groups such as the Gay and Lesbian Medical Association, the Christian Medical & Dental Associations and the National Medical Association -- an organization of black doctors -- allow patients to search their listings for free. Providers who belong to these groups can also post a listing.

    The commercial sites also feature free searches. Most allow providers to post basic information at no charge; some impose a fee for a more detailed listing. A few sites that offer free registrations of providers are supported by advertising and donations.

    It's not hard to see the sites' appeal, said Arthur Levin, director of the Center for Medical Consumers, a consumer advocacy group based in New York. "I think it's understandable given concerns about cultural sensitivity [that] people may feel more comfortable with a doctor if they look like them or think like them."

    But there should be more to a patient's decision, Levin said. "If you're just searching one characteristic, which only has to do with what they believe or who they are, I think that's not a very good way to choose a physician."

    David Stevens, executive director of the Christian Medical & Dental Associations, said the site's database was created in response to calls from patients seeking "Christian" referrals. Users of the service, he said, want a physician who "deeply cares about them as an individual" and who shares "their same worldview on clinical issues." The database gets about 65,000 hits per month, he said.

    The gay and lesbian group's search engine emphasizes the importance of finding a doctor with whom patients can feel comfortable discussing their sexual orientation, said Joel Ginsberg, executive director of the group. "Have you ever wished that you had a doctor, dentist, therapist or chiropractor who understood and was sensitive to the needs of gay, lesbian, bisexual, transgendered or intersex people?" asks the database's introductory page. "Being out to your health care providers is important to ensure that you receive proper health care." Among the care that may be tailored to a patient's sexual habits and preferences are testing for sexually transmitted diseases and screening and vaccinations against hepatitis.

    But while the Web sites clearly label a doctor's stated affinities, they offer no help in verifying the practitioner's credentials or assessing quality of care -- other factors that Levin says should go into choosing a doctor. Here, the sites tell patients they're on their own.

    Findablackdoctor.com, for instance, carries this disclaimer: "Users are warned to check and verify the credentials of any alleged health care provider before consenting to any and all courses of treatment. Materials found on the site are for reference purposes only and are not recommended or endorsed by the owners of findablackdoctor.com."More doctors, meanwhile, are taking note of the sites. Jacques Conaway, medical director of the sleep centers at Franklin Square Hospital Center and Harbor Hospital in Baltimore, explained his registration two months ago on findablackdoctor.com this way: "I realize that an increasing number of my patients are Internet-savvy, and whenever I have the opportunity, I like to leave a fingerprint out there" online, he said. "I certainly have a population of patients that really prefer having an African American physician. . . . I think that sitting down with someone who has shared cultural experiences makes the entire history and physical process easier and smoother for the patient."

    The number of doctors listed on the sites varies from just over 100 to well into the thousands. Findablackdoctor.com has about 125 listings, according to Dina Strachan, founder of the site. A majority of the Gay and Lesbian Medical Association's 1,000 members are listed in its database, Ginsberg reported. The Christian Medical & Dental Association's 17,000 members automatically get listed unless they opt out, Stevens said. BlackDoctorFinder.com says its listings number "in the thousands," but would not be more specific. The National Medical Association includes about 900 members in its database. And BlackDoctor.org lists more than 1,000 providers, according to Reggie Ware, the Web site's founder and CEO.

    A general search last week within 25 miles of the Washington Zip code 20071 turned up only four doctors on findablackdoctor.com. Searching that Zip code produced zero results on BlackDoctorFinder.com, but changing to 20721, a Zip code in Prince George's County, produced 11 results.

    A search on the gay and lesbian site for "general practice" physicians in area code 202 produced four results. Searching for a District doctor on the Christian site's database produced 15 results. And searching BlackDoctor.org for family practice physicians in the District produced a list of just two doctors.

    Conaway predicts this will change as more patients learn about affinity medical sites.

    "I'm finding an increasing number of my patients are finding me" on the Internet, Conaway said. "It's a great tool that, if anything, is underutilized." For some patients, he said, "going into an office and you see a black face there, in some minds, [that] makes the playing field a little more level." ยท


    Find a Doc:
    Doctors With Special Affinities: free online services that help patients find doctors who share their race, religion or sensitivity to sexual orientation issues include the following:

    BlackDoctor.org The site allows users to search for black doctors by city/state, specialty or Zip code. Patients may also call 1-888-75doctor. (Look for "Find a Doctor.")

    BlackDoctorFinder.com: search for a black health care provider by Zip code, specialty or name. Site also features health news that affects African Americans.

    Christian Medical & Dental Associations: the group allows users to search for doctors and dentists by specialty or state. (Select "Christian Doctor Search.")

    Findablackdoctor.com:> search for black health care providers by Zip code, last name, city/state, specialty and foreign languages spoken.

    Gay and Lesbian Medical Association Use area code, city/state and specialty to search for providers. Narrow the list by selecting "TG/TS-aware" - shorthand for a provider who is "supportive and informed of transsexuality, cross-dressing, and other transgender issues" - and "kink-aware" - shorthand for a provider who is "supportive and informed about alternative sexual practices" such as sadomasochism and other fetishes. (Select "Health Care Referrals.")

    National Medical Association: the group allows patients to search for black doctors by Zip code. Patients may also call 1-888-662-7497. (Click on "The NMA" on the left, then select "Physician Locator Service.")

  • #2
    I don't really care about race or religion as much as where the doc went to med school and residency. When I see a certain name of school or program, I automatically cross it off my list. After that it's whoever has the first available appt. Whenever possible though I ask DH's friends for recommendations. For the record, I only see one doctor regularly and she's a black female. I agree with Jenn that I also prefer females over males.

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    • #3
      Originally posted by Momof4
      I'm on the other side, I only see male docs. Our childrens' main pediatrician is a male but we see the females in the office as well and they have been great. For my Ob/Gyn I've tried female docs but never found them as compassionate or knowledgeable as their male counterparts. This was true for me way before my hubby chose to go into Ob/Gyn. The majority of my friends see males as well for the same reasons. My Ob/Gyn for the last 14 years has just retired so I'm looking again. Will I only look for males? No, I want to find someone that respects me, someone I feel comfortable with, and someone who is extremely knowledgeable.
      Tara
      I'm the same way. In my experience, I've preferred the male ob/gyns much more than the female ones for the same reaons you listed. Like you, I will see both male and female docs, but the doctors I've liked best were those with whom I felt comfortable and felt were thorough in their care - and in my experience, it's been the male ob/gyns. Currently, I'm seeing a male ob who is just excellent and so thorough.
      Wife of Ophthalmologist and Mom to my daughter and two boys.

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      • #4
        Tara-

        We've had similar discussions here before- like does whether or not a pediatrician has kids make a difference, does a female urologist or a male ob/gyn matter, etc.

        My husband has had patients for whom religious reasons required that either the female spouse be seen by a female physician OR the husband had to stay in the room. (I've had a similar situation with a severely self-abusive Orthodox Jewish woman whose father (the rabbi) freaked when he realized that if we needed to do a restraint we didn't have time to wait for a female staff person.)

        Part of the reasons why I go to female docs (especially on the civilian side) is because I want female docs to be as successful as their male counterparts. So, when handed the stupidly large book of 'providers' and told, "pick one" I went for 1) location and 2) female. Since the provider books rarely included information like if they were boarded or where they went to school- I usually just closed my eyes and picked. Once I picked my doctor because her name was Tracie- and I figured it was good odds that someone whose name ended in 'ie' was closer to my age than someone whose name ended in 'y'. and it was a good guess.

        Jenn

        PS- for those of you who are particularly religious, does it matter to you what religion your physician is?

        Comment


        • #5
          For the most part, it doesn't matter to me. Right now, my kids pediatrician is male but I didn't know that until I called -- I only had the name "Dr X" recommended to me. I like to see both male and female, though, so that my kids see the example of both male and female doctors. Honestly, that was a downside to finding a male dentist (in addition to male ped) for my daughter but she likes him and that is the most important think. I wouldn't switch providers solely for that reason.

          I'm also in the male ob/gyn camp and agree Tara and JaneDoe's comments on a general level. I would not decline to see a male for only that reason. I had only two practices to choose from for my last pregnancy -- the unversity or a primarily female practice. I decided to try the private practice. For the most part, it was fine. My current gyn is female and I'll probably see her again. But this time I'm kicking out the medical student, male or female, because who needs two paps and what the he** was I thinking last time?

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          • #6
            I have had both male and female OB/Gyns and they have all been fine. I think that women who will only see female providers because they think females are more empathetic are deluding themselves, though, because most females who have been through an OB residency are tough cookies (at least the ones in DH's program were). They either hadn't had kids yet, or if they had, they felt like if they could do it with the demands of the residency, no one else had the right to complain about *anything*. Perhaps hearing the chit-chat at parties influenced me negatively, but I sure didn't hear the male residents talking about their patients with the same contempt as the female residents.

            The two female providers I had were fine, but I was friends with both of them, so it was a little weird to have them looking at my nether regions, you know? For my kids, now that they are getting older, I am taking them to a male family practice doc who works for the same company as DH and has 3 sons, older than my boys. They have seen male and female pediatricians up until now. I thought my oldest, in particular, might be more comfortable with a male doctor. I don't really worry about my kids getting a stereotypical idea of only males being doctors, with as many female doctors as DH has always worked with.

            As far as the religious aspect, I would try to only choose a pro-life OB/Gyn, but they wouldn't have to have my exact beliefs.

            Sally
            Wife of an OB/Gyn, mom to three boys, middle school choir teacher.

            "I don't know when Dad will be home."

            Comment


            • #7
              Regarding religion and choosing a physician:

              I have stuck to LDS obstetricians in the past because I do not want to support a physician who does voluntary abortions (and, LDS obstetricians who are religiously observant can only perform medically necessary abortions).

              I had a non-LDS ob with my third pregnancy very briefly. When I started getting depressed and overloaded during that pregnancy (which occured during my husband's intern year of residency - hard, yah think?) this ob quickly and strongly suggested I have an abortion. No kidding. I immediately turned around and switched to a talented, experienced LDS ob. When I look at my little daughter now and think of if I had followed this once trusted person's advice during a time when I was very unhappy and easily influenced.... shudder

              Other than that I really don't care what gender any of my doctors are. I also don't care about their ages. I DO care about their competency, intelligence, and talent in their chosen fields.
              Who uses a machete to cut through red tape
              With fingernails that shine like justice
              And a voice that is dark like tinted glass

              Comment


              • #8
                Hey...if they don't have nice behinds...I don't see them!

                hehehe

                Just kidding. I see mostly women docs.....I feel more comfortable with disrobing in front of the same gender. My oncologist is a male and I'm very comfortable with him in terms of competence etc. I just wouldnt ever....undress completely in front of him. :!

                I tend to choose based on gender...then see if I'm comfortable with them and my perception of their level of knowledge.

                I had a doc who graduated from Harvard and did residency there too...and I found out later that he basically..sucked. He was a nice guy...but a lousy doctor. A friend of mine went to an average school and did an...average residency...and she is one of the best Family Practitioners here.

                kris
                ~Mom of 5, married to an ID doc
                ~A Rolling Stone Gathers No Moss

                Comment


                • #9
                  I get recommendations from other people, and then I look them up. I find out where they went to med school, and where they did residency. This mostly does not influence my decision, but I would like to know. I figure if they went to Harvard, I don't want them. I prefer average med school docs. But, I haven't really run into that, so mostly I'm kidding. I do look at how long they have been out of med school. I do not want a really old doc. A lot of them are stuck in their ways, and I want someone who is more willing to work with me as a patient then to tell me what to do.

                  Kids pediatrician - male, totally cool.
                  Family practitioner - female, really, really, really awesome.
                  My OB/GYN - Currently, male, makes me a bit uncomfy because I don't like their dressing gowns - they are paper and suck. Most of my OB/GYNs have been male, because most of the places I have lived have very few females available. I have had one female OB/GYN and she was awesome! My last OB was a male with a gigantic comical moustache, but he was great. He was one of the only doc in the area do do abortions, and got threats, and I thought it was noble. He was also just a great doc who listened to me and helped me and never suggested that I get an abortion in my very difficult, complicated pregnancy. That's just bad. I went to a guy before that, and he did an exam on me without a nurse present, and I never went back. There was nothing inappropriate. It just felt wrong. THe OB/GYN is one of the hardest to get right, I think.
                  Heidi, PA-S1 - wife to an orthopaedic surgeon, mom to Ryan, 17, and Alexia, 11.


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                  • #10
                    I generally only see female doctors that used to be males. I figured it's the best of both genders.
                    Mom of 3, Veterinarian

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