Saturday, August 18, 2018

Diversity isn't just about role models: Alsan, Garrick and Graziani on black male doctors and patients

Medical compliance--following the doctor's "orders,"--is a big issue in medical care, and here's an article that reports a novel field experiment suggesting that black male doctors treating black men may have more success than non-black docs.

Does Diversity Matter for Health? Experimental Evidence from Oakland
Marcella Alsan, Owen Garrick, Grant C. Graziani
NBER Working Paper No. 24787

"We study the effect of diversity in the physician workforce on the demand for preventive care among African-American men. Black men have the lowest life expectancy of any major demographic group in the U.S., and much of the disadvantage is due to chronic diseases which are amenable to primary and secondary prevention. In a field experiment in Oakland, California, we randomize black men to black or non-black male medical doctors and to incentives for one of the five offered preventives — the flu vaccine. We use a two-stage design, measuring decisions about cardiovascular screening and the flu vaccine before (ex ante) and after (ex post) meeting their assigned doctor. Black men select a similar number of preventives in the ex-ante stage, but are much more likely to select every preventive service, particularly invasive services, once meeting with a doctor who is the same race. The effects are most pronounced for men who mistrust the medical system and for those who experienced greater hassle costs associated with their visit. Subjects are more likely to talk with a black doctor about their health problems and black doctors are more likely to write additional notes about the subjects. The results are most consistent with better patient-doctor communication during the encounter rather than differential quality of doctors or discrimination. Our findings suggest black doctors could help reduce cardiovascular mortality by 16 deaths per 100,000 per year — leading to a 19% reduction in the black-white male gap in cardiovascular mortality.

While there's no substitute for the kind of serious science reported in the paper above, below is a very believable anecdotal account in an interview published in Stat that suggests that companies seeking to solve medical problems afflicting women may have more success with venture capital firms that have women partners:

A women’s health startup tried to drum up interest for a much-needed drug. Many men didn’t get it

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