MANAGED CARE: NMA Says HMOs Exclude Black Doctors
The managed care industry "systematically exclude African American physicians from their provider networks" and are "terminating the contracts of some who are already members," the National Medical Association, representing 25,000 black doctors, charged yesterday. Walter Shervington, president of the NMA, said that African American doctors "are routinely excluded from health plans primarily because they tend to serve mostly black patients who tend to be sicker and require more expensive medical care" (Murray, AP/Baltimore Sun, 1/25). "This practice is not only racist but ultimately compromises patient care. Patients feel more involved in their health care decisions when they receive care from doctors of a similar race," said Dr. Gary Dennis, former NMA president (Shepard, AP/Contra Costa Times, 1/25). But a University of California-San Francisco study, published in the March 4, 1998 Journal of American Medicine, showed that "nonwhite doctors were no more likely than white doctors to be denied or terminated from HMO contracts" and that minority doctors had the same or greater participation in HMOs than white doctors. Although the panel of doctors at yesterday's new conference conceded they had "little more than anecdotal evidence," they said they hope increased public awareness "will fuel further research and documentation" (AP/Baltimore Sun, 1/25).
On the Defense
Charles Cutler, chief medical officer of the American Association of Health Plans responded to the allegations, saying, "The argument that we would exclude black doctors makes no sense." He said that the percentage of black doctors in America "dwarfed" by the African American population "might give the impression that HMOs exclude blacks" (AP/Contra Costa Times, 1/25). AAHP spokesperson Susan Pisano said the agency will schedule meetings with the NMA to discuss doctors' experiences. She said, "We don't know as much as we need to know. We want to talk to the physicians firsthand to try and do what we can to address their concerns. It's in our best interest, as well as our patients' interest, to have our networks be diverse." The NMA suggests that HMO physician groups "reflect the ethnic makeup of the patients they serve" (AP/Baltimore Sun, 1/25).