The time spent in office visits with psychiatrists has equalized among blacks and whites in recent years

Disparities/Minority Health
The time spent in office visits with psychiatrists has equalized among blacks and whites in recent years

In recent years, there has been progress in eradicating racial differences in the time office-based psychiatrists spend with patients, reveals a new study. For example, from 2001 to 2003, black patients had office-based visits with psychiatrists that were an average of 4.4 minutes shorter than visits by whites (28.3 vs. 32.7 minutes). This difference was reduced to 3.5 minutes after accounting for other factors that could affect visit length. However, by 2004 to 2006, the time spent with the psychiatrist was about the same for black and white patients. Between these periods, there were longer visits by black patients rather than shorter visits by white patients. This suggests that the change was not mediated by the pattern of psychotherapy or medication visits.

This gain is good news against the backdrop of persisting racial disparities in access and quality of mental health care, note the researchers. They calculated face-to-face time between psychiatrists and black and white patients based on data from the 2001-2006 National Ambulatory Medical Care Survey of U.S. office-based physicians. They analyzed a total of 7,094 office visits to psychiatrists made by white patients and 504 visits by black patients.

After controlling for relevant patient, psychiatrist, and practice characteristics, the only factors in which there were significant racial differences in visit length in 2004 to 2006 were female patient sex and Medicare payment. When Medicare was the primary source of payment, visits by black patients were an average of 3.5 minutes shorter than visits by white patients. Blacks are two to three times less likely than whites to have private supplemental insurance that covers charges above Medicare-approved amounts. Psychiatrists treating patients with supplemental policies, regardless of patient race, may tend to provide longer visits, suggest the researchers. During the same period, psychiatric visits by black women were an average of 5.4 minutes shorter than visits by white women. The study was supported in part by the Agency for Healthcare Research and Quality (HS16097).

See "Racial differences in visit duration of outpatient psychiatric visits," by Mark Olfson, M.D., M.P.H., Donald K. Cherry, M.S., and Roberto Lewis-Fernandez, M.D., in the February 2009 Archives of General Psychiatry 66(2), pp. 214-221.