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Study: Asian patients with psoriasis get less time at dermatologist visit

Study: Asian patients with psoriasis get less time at dermatologist visit
New research suggests that Asian patients with psoriasis have much shorter visits with their dermatologists compared to patients of other races and ethnicities. Photo by Psoriasis-Netz/Flickr

Aug. 3 (UPI) -- Asian patients with psoriasis have much shorter visits with their dermatologists compared with patients of other races and ethnicities, a study released Wednesday suggests.

Yet, the researchers said Asian individuals "tend to present with more severe psoriasis," a painful, chronic inflammatory skin condition, than other individuals.

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According to the research letter, published in JAMA Dermatology, the mean duration of dermatologists' visits for psoriasis was 9.2 minutes with Asian patients, 15.7 minutes with Hispanic or Latino patients, 20.7 minutes with non-Hispanic Black patients and 15.4 minutes with non-Hispanic White patients.

The researchers said dermatologists' visits with Asian patients had a 39.9% shorter mean duration versus visits with White patients, and a 40.6% shorter mean duration versus visits with non-Asian patients as a single group.

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The physician-researchers from the Keck School of Medicine's Department of Dermatology at the University of Southern California-Los Angeles, said their study supports previous studies' results in which Asian patients were found to be less likely to receive counseling from physicians compared with White patients.

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The researchers said the underlying factors accounting for differences in lengths of dermatology visits for psoriasis observed in their study are unclear. But they posited that "unconscious bias" and "cultural differences in communication" could be partly responsible and said further research is needed.

The bottom line, they said, is that ineffective physician-patient communication can result in "poor treatment adherence, comprehension, satisfaction and outcomes for the patient."

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Yet, it's best to get the scientific evidence before jumping to the conclusion that conscious racism is at play, Dr. Robert Brodell, a practicing dermatologist in Jackson, Miss., told UPI in a phone interview.

"I just never see overt racism among physicians with whom I work," though it might have been broadly true several decades ago across the United States, said Brodell, professor and past founding chair of the department of dermatology at the University of Mississippi Medical Center.

However, Brodell said, there might be "subconscious views that lead a physician to treat some patients differently," or perhaps cultural differences among some patients leading them to come to the doctor for simpler problems that can be handled more quickly.

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He added: "Some patients born in other countries are trained to revere doctors and not question things they say. It is up to the physician to try to break through these kinds of barriers."

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For this study, the investigators analyzed 2010 through 2016 data from the National Ambulatory Medical Care Survey, adjusting for age, sex, type of visit (follow-up or new patient), visit complexity, insurance status, psoriasis severity and "complex topical regimen." Some 4.2 million patient visits for psoriasis were identified.

The Asian patients were by and large younger, and followed a more complex topical regimen for psoriasis, than the patients of other races and ethnicities in the study.

Race and ethnicity were self-reported by the patients.

The researchers, in outlining the study's limitations, noted that dermatology visits' duration was self-reported by the physician or their staff.

They also cited missing data on race and ethnicity, and said those patients who didn't report this information "may have different characteristics affecting visit duration versus those who did report" it.

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