Document Type
Article
Publication Date
Winter 12-3-2018
Journal / Book Title
Special Issue: Health Equity
Abstract
Study Objectives
To determine whether the name and accent cues that the caller is Black shape physician offices’ responses to telephone‐based requests for well‐child visits.
Method and Data
In this pilot study, we employed a quasi‐experimental audit design and examined a stratified national sample of pediatric and family practice offices. Our final data include information from 205 audits (410 completed phone calls). Qualitative data were blind‐coded into binary variables. Our case‐control comparisons using McNemar's tests focused on acceptance of patients, withholding information, shaping conversations, and misattributions.
Findings
Compared to the control group, “Black” auditors were less likely to be told an office was accepting new patients and were more likely to experience both withholding behaviors and misattributions about public insurance. The strength of associations varied according to whether the cue was based on name or accent. Additionally, the likelihood and ways office personnel communicated that they were not accepting patients varied by region.
Conclusions
Linguistic profiling over the telephone is an aspect of structural racism that should be further studied and perhaps integrated into efforts to promote equitable access to care. Future research should look at reactions to both name and accent, taking practice characteristics and regional differences into consideration.
DOI
https://doi.org/10.1111/1475-6773.13089
MSU Digital Commons Citation
Leech, Tamara; Irby-Shasanmi, Amy; and Mitchell, Anne L., "“Are you accepting new patients?” A pilot field experiment on telephone-based gatekeeping and Black patients’ access to pediatric care" (2018). Department of Public Health Scholarship and Creative Works. 122.
https://digitalcommons.montclair.edu/public-health-facpubs/122
Published Citation
Leech, Tamara GJ, Amy Irby‐Shasanmi, and Anne L. Mitchell. "“Are you accepting new patients?” A pilot field experiment on telephone‐based gatekeeping and Black patients’ access to pediatric care." Health services research 54 (2019): 234-242. Harvard
Included in
Applied Behavior Analysis Commons, Child Psychology Commons, Clinical Epidemiology Commons, Clinical Psychology Commons, Epidemiology Commons, Health Services Administration Commons, Health Services Research Commons, International Public Health Commons, Other Public Health Commons, Patient Safety Commons, Politics and Social Change Commons, Public Health Education and Promotion Commons, Sociology of Culture Commons, Work, Economy and Organizations Commons