Patient Management
CHINELO EKE, DDS
RESIDENT
Virginia Commonwealth University, Richmond, VA
VIRGINIA COMMONWEALTH UNIVERSITY SCHOOL OF DENTISTRY
HENRICO, Virginia, United States
Carlos S. Smith, DDS, MDiv, FACD
ASSOCIATE PROFESSOR & Director, DEI and Director, Ethics Curriculum
VCU School of Dentistry
RICHMOND, Virginia, United States
Jayakumar Jayaraman, BDS, MDS, FDSRCS, MS, PhD (he/him/his)
Associate Professor
VCU Pediatric Dentistry
Virginia Commonwealth University
Richmond, Virginia, United States
Tiffany Williams, DDS
ASSOCIATE PROFESSOR
VIRGINIA COMMONWEALTH UNIVERSITY
RICHMOND, Virginia, United States
Carlos S. Smith, DDS, MDiv, FACD
ASSOCIATE PROFESSOR & Director, DEI and Director, Ethics Curriculum
VCU School of Dentistry
RICHMOND, Virginia, United States
Purpose: Studies have drawn varying conclusions on the importance of a racially concordant patient provider relationship. Medical mistrust has continued to garner attention as healthcare enterprises thread equity, diversity and inclusion throughout their organizational policies, practices and systems.
Methods: Parents/caregivers of pediatric patients at VCU Pediatric Dentistry were invited to participate. Surveys included questions about demographics, racial concordance, language preference, and the validated Group-Based Medical Mistrust Scale.
Results: A total of 246 guardians completed the survey. For guardians, 40% reported Black or African American, 31% Hispanic, and 19% Caucasian. Seventy-one percent of guardians reported speaking English, 18% Spanish, and 11% bilingual. Ten percent indicated they preferred a provider with the same race as their child, 57% prefer the provider speak to the child in the primary language spoken at home, and 56% prefer the provider speak to them in the primary language spoken at home. Preference for same-race providers was not significantly associated with guardian race (p-value=0.2860) or child’s race (p-value=0.2136). An increase in the Group-Based Medical Mistrust Scale was significantly associated with preference for same-race providers for children (OR: 1.09; 95% CI: 1.04-1.14). Preference for a provider who speaks the primary language spoken at home was significantly associated with the patient’s home language (p-value=.0002).
Conclusions: While race was shown to be a nominal factor in provider selection, those parents/guardians who expressed a higher degree of medical mistrust, were significantly more likely to desire a racially concordant provider relationship. Mitigating systemic barriers in healthcare should include a focus on embracing language differences and acknowledging historical lapses in ethics, cultivating trust in the healthcare system.