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Better training and more diversity needed for Patients of Color

Within the US, there has been a push to increase racial and ethnic diversity within the dermatology work force. Efforts have also begun to include more racial and ethnic minorities within clinical trials. Providers who work within the field of dermatology have expressed there is a lack of curriculum devoted to the care of skin and hair of black patients. For example, among dermatology residency programs in 2008, only 25.4% of chief residents and 19.5% of dermatology program directors reported having any lectures on skin of color from an acknowledged expert (Nijhawan, Jacob, Woolery-Lloyd, 2008).

In the recently published JAMA Dermatology study, the goal was to determine the perceptions black patients have about the care they receive from dermatologists. In this cross-sectional study, all patients were cared for in a specialized Skin of Color Clinic (SOCC). These patients were asked to compare the care they received in the SOCC clinic with providers they previously saw who were not part of the SOCC. When compared to non-SOCC dermatologists, more favorable scores were found for SOCC dermatologists in terms of patient satisfaction, interaction style and cultural awareness.

In this study, the SOCC dermatologists were found to provide “unique and uniformly beneficial care to black patients.” Care satisfaction appeared most related to dermatologists’ interpersonal style and specialized knowledge in care of black skin and hair. Participants expressed frustration when relating their prior interactions with dermatologists who seemed to lack this knowledge and appreciated the expertise of dermatologists in the SOCC. Specifically, the participants felt the SOCC dermatologists showed greater respect, dignity and understanding of the participants when compared to their previous non-SOCC dermatologists. Additionally, they felt the SOCC dermatologists were more trustworthy. The authors report the findings of this study ”suggest black patients’ dermatologic care satisfaction would increase if dermatologists underwent enhanced residency training in skin of color, cultural competency, cost-conscious care, and empathic communication skills, and if there were greater dermatology workforce diversity.”

“Care satisfaction appeared most related to dermatologists’ interpersonal style and specialized
knowledge in care of black skin and hair. Participants expressed frustration when relating their
prior interactions with dermatologists who seemed to lack this knowledge and appreciated the
expertise of dermatologists in the SOCC.”

The study is limited by its small number of participants.

Byline: Sarah B. W. Patton, MSHS, PA-C
Posted September 3, 2019

Source: Gorbatenko-Roth K, Prose N, Kundu RV, et. al. Assessment of black patients’ perception of their dermatology care. JAMA Dermatol 2019. Published online August 21, 2019. doi:10.1001/jamadermatol.2019.2063