Inequality in Health Care: Unjust, Inhumane, and Unattended!
Authors: Talmadge E. King, Margaret B. Wheeler
Journal: Annals of Internal Medicine (2004)

Editorials16 November 2004Inequality in Health Care: Unjust, Inhumane, and Unattended!Talmadge E. King Jr, MD and Margaret B. Wheeler, MDTalmadge E. King Jr, MDFrom University of California, San Francisco, San Francisco, CA 94110. and Margaret B. Wheeler, MDFrom University of California, San Francisco, San Francisco, CA 94110.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-10-200411160-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The reputation and integrity of American medicine have been sullied. A striking 60% of Americans are unsatisfied with the health care system (1). Our system is unsafe—preventable deaths in hospitals exceed deaths attributable to such feared threats as motor vehicle accidents or AIDS (2). Physicians and medical institutions are mistrusted, with widespread concern that entanglements among physicians, health centers, and big businesses (managed care companies and the pharmaceutical industry) motivate physicians to act out of interests other than their patients' well-being (3, 4). Despite being the most expensive health care system in the world (1), the U.S. health care system ...References1. The U.S. Health Care System: Best in the World, or Just the Most Expensive? Division of Lifelong Learning Bureau of Labor Education Briefing Paper. Orono, ME: Univ of Maine; Summer 2001. Accessed at dll.umaine.edu/ble/U.S.%20HCweb.pdf on 5 October 2004. Google Scholar2. Kohn LT, Corrigan JM, Donaldson MS, eds. To Err Is Human: Building a Safer Health System. Washington, DC: National Academy Pr; 2001. Google Scholar3. Bodenheimer T. Uneasy alliance—clinical investigators and the pharmaceutical industry. N Engl J Med. 2000;342:1539-44. [PMID: 10816196] CrossrefMedlineGoogle Scholar4. Moynihan R. Who pays for the pizza? Redefining the relationships between doctors and drug companies. 1: entanglement. BMJ. 2003;326:1189-92. [PMID: 12775621] CrossrefMedlineGoogle Scholar5. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academies Pr; 2001. Google Scholar6. Bach PB, Pham HH, Schrag D, Tate RC, Hargraves JL. Primary care physicians who treat blacks and whites. N Engl J Med. 2004;351:575-84. [PMID: 15295050] CrossrefMedlineGoogle Scholar7. Bradley EH, Herrin J, Wang Y, McNamara RL, Webster TR, Magid DJ, et al. Racial and ethnic differences in time to acute reperfusion therapy for patients hospitalized with myocardial infarction. JAMA. 2004;292:1563-1572. [PMID: 15467058] CrossrefMedlineGoogle Scholar8. Smedley BD, Stith AY, Nelson AR, eds. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academy Pr; 2002. Google Scholar9. Isaacs SL, Schroeder SA. Class—the ignored determinant of the nation's health. N Engl J Med. 2004;351:1137-42. [PMID: 15356313] CrossrefMedlineGoogle Scholar10. Smedley BD, Stith AY, Colburn L, Evans CH. The Right Thing to Do, The Smart Thing to Do: Enhancing Diversity and Health Professions. Washington, DC: National Academy Pr; 2001. Google Scholar11. Lillie-Blanton M, Brodie M, Rowland D, Altman D, McIntosh M. Race, ethnicity, and the health care system: public perceptions and experiences. Med Care Res Rev. 2000;57 Suppl 1 218-35. [PMID: 11092164] CrossrefMedlineGoogle Scholar12. Wilson E, Grumbach K, Huebner J, Agrawal J, Bindman A. Medical student, physician and public perceptions of health care disparities. Fam Med. 2004;36:715-21. MedlineGoogle Scholar13. Long JA, Chang VW, Ibrahim SA, Asch DA. Update on the health disparities literature. Ann Intern Med. 2004;141:805-12. LinkGoogle Scholar14. van Ryn M. Research on the provider contribution to race/ethnicity disparities in medical care. Med Care. 2002;40:I140-51. [PMID: 11789627] CrossrefMedlineGoogle Scholar15. Cooper LA, Roter DL, Johnson RL, Ford DE, Steinwachs DM, Powe NR. Patient-centered communication, ratings of care, and concordance of patient and physician race. Ann Intern Med. 2003;139:907-15. [PMID: 14644893] LinkGoogle Scholar16. Groman R, Ginsburg J. Racial and ethnic disparities in health care: a position paper of the American College of Physicians. Ann Intern Med. 2004;141:226-32. [PMID: 15289223] LinkGoogle Scholar17. Fernandez A, Schillinger D, Grumbach K, Rosenthal A, Stewart AL, Wang F, et al. Physician language ability and cultural competence. An exploratory study of communication with Spanish-speaking patients. J Gen Intern Med. 2004;19:167-74. [PMID: 15009796] CrossrefMedlineGoogle Scholar18. Bach PB, Schrag D, Brawley OW, Galaznik A, Yakren S, Begg CB. Survival of blacks and whites after a cancer diagnosis. JAMA. 2002;287:2106-13. [PMID: 11966385] CrossrefMedlineGoogle Scholar19. Ayanian JZ, Cleary PD, Keogh JH, Noonan SJ, David-Kasdan JA, Epstein AM. Physicians' beliefs about racial differences in referral for renal transplantation. Am J Kidney Dis. 2004;43:350-7. [PMID: 14750101] CrossrefMedlineGoogle Scholar20. Grumbach K, Bodenheimer T. Can health care teams improve primary care practice? JAMA. 2004;291:1246-51. [PMID: 15010447] CrossrefMedlineGoogle Scholar21. Lavizzo-Mourey R, Lumpkin JR. From unequal treatment to quality care. Ann Intern Med. 2004;141:221. [PMID: 15289219] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Talmadge E. KingJr, MD; Margaret B. Wheeler, MDAffiliations: From University of California, San Francisco, San Francisco, CA 94110.Disclosures: None disclosed.Corresponding Author: Talmadge E. King Jr., MD, San Francisco General Hospital, Room 5H22, 1001 Potrero Avenue, San Francisco, CA 94110; e-mail, [email protected]ucsf.edu.Current Author Addresses: Dr. King: San Francisco General Hospital, Room 5H22, 1001 Potrero Avenue, San Francisco, CA 94110. Dr. Wheeler: University of California, San Francisco, 1001 Potrero Avenue, San Francisco, CA 94110. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUpdate on the Health Disparities Literature Judith A. Long , Virginia W. Chang , Said A. Ibrahim , and David A. 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Phillips, MD, MPH, Alicia Fernandez, MD, Elizabeth Jacobs, MD, MPP, and Jacqueline Bowles, MD, MSCEDatabases, differences, and disparitiesParallels and distinctions between health care quality improvement and health care disparities reductionA perspective on African American participation in clinical trialsLooking Forward: Cross-cutting Issues in the Collection and Use of Racial/Ethnic DataPatients Report Positive Impacts of Collaborative Care 16 November 2004Volume 141, Issue 10Page: 815-817KeywordsCommunication in health careExerciseHabitsHealth careHealth care providersHealth disparitiesHealth economicsPatientsRacial and ethnic issuesSmoking cessation ePublished: 16 November 2004 Issue Published: 16 November 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...