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Study: Blacks Less Likely to be Referred to a Neurologist, More Likely to Pay More for Worse Care

A recent study published in the medical journal of the American Academy of Neurology found that Black patients pay more for worse health care services. (Charles Krupa/Associated Press)

Black patients make fewer outpatient visits to neurologists than their white counterparts but pay more, according to a recently released study published in Neurology, the medical journal of the American Academy of Neurology.

Black patients were 30 percent less likely to be referred to a neurologist’s office than white patients, even after accounting for demographic factors, insurance and health status differences. Hispanics were 40 percent less likely to see neurologists than whites, according to the study.

The study analyzed nationwide data from 2006-2013 from the Medical Expenditure Panel Survey, which surveyed nearly 280,000 patients and their health care providers. Asians and people of other races were not included in the analysis due to too small of a sample size.

The study suggested that failure to receive adequate outpatient neurology care can have medical as well as financial costs.

It found white patients with neurologic illnesses including strokes, seizures, multiple sclerosis and Parkinson’s disease were less likely to be treated in emergency departments, had fewer hospital stays and paid lower hospital expenses compared to Black patients.

Medical costs for Black people were $1,485 per person, compared to $599 per white person.

Part of the problem lies with a lack of access to information in nonwhite communities, according to Altaf Saadi, neurologist and chief resident at Massachusetts General and Brigham and Women’s Hospital in Boston, who was the study’s lead author. But racial stereotypes are a big factor as well, she said.

“Take Alzheimer’s,” she told “So much depends, in that case, on the physician’s interaction with the patient and the family. And to think that wouldn’t be influenced by stereotypes on the part of the physician is not being realistic about human nature.”

A lack of diversity in health care has been at the root of other problems associated with racial and ethnic disparities in medical care, studies have revealed.

Monique Tello, a Boston physician, wrote a blog associated with Harvard Medical School, calling for providers and patients to address racism and discrimination in medicine.

The new study concluded that neurologists should engage in policy discussions about access to health care to help close the racial and ethnic disparities in neurological care and also work to educate medical professionals about cultural biases, increase diversity in neurologic care and improve patient education about neurologic illness.

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