Does Patient Race Affect Physical Therapy Treatment Recommendations?
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Does Patient Race Affect Physical Therapy Treatment Recommendations? Alyson M. Cavanaugh 1,2
&
Mitchell J. Rauh 2
Received: 9 June 2020 / Revised: 28 September 2020 / Accepted: 12 October 2020 # W. Montague Cobb-NMA Health Institute 2020
Abstract Background Racial disparities in the medical treatment of adults with arthritis are well-documented. Disparities with physical therapy treatment have yet to be thoroughly evaluated. Objective To investigate the association of patient’s race with physical therapy treatment recommendations for patients with arthritis. Design Online survey. Methods Physical therapists, physical therapist assistants, student physical therapists, and student physical therapist assistants within a Southern California county completed an online survey that presented a case vignette with a randomly assigned photograph of a White or Black woman. Recommendations for the plan of care included frequency of visits and number of exercises in the home exercise program (HEP), referrals to other healthcare professionals, and explicit ranking of how patient characteristics impacted the treatment planning were compared between respondents who viewed the Black or White patient. Results Eighty-three participants completed the survey, and all participants reported that the patient was appropriate for physical therapy. Most participants (66.3%) reported that they would recommend a frequency of therapy of 2–3 times weekly. All participants recommended including a HEP. There were no statistically significant differences by patient race in recommendations for treatment frequency or referrals to other healthcare team members. HEP prescription was a median of four exercises, but participants who viewed the Black patient were more likely to recommend fewer exercises than those who viewed the White patient (p = 0.03). Explicitly, 96.1% of participants reported that race did not impact their treatment recommendations. Conclusions In most aspects of treatment planning, the patient’s race did not impact recommendations by physical therapy professionals. The lower exercise prescription assigned to the Black patient may represent a disparity that merits further attention. Keywords Rehabilitation . African-American . Disparity . Arthritis . Total knee arthroplasty
Introduction In the USA, a prominent example of racial disparities in healthcare involves the medical treatment of older adults with knee arthritis [1–4]. Black adults are less likely to receive any type of conventional care or complementary/alternative medicine (CAM) treatment for arthritis [1], and suffer higher * Alyson M. Cavanaugh [email protected] Mitchell J. Rauh [email protected] 1
San Diego State University/University of California San Diego, Joint Doctoral Program in Public Health, CA San Diego, USA
2
Doctor of Physical Therapy Program, San Diego State University, CA San Diego, USA
levels of disability [5]. Older Black adults with end-stage arthritis and indications for total knee arthroplasty (TKA) are less likely than Whites to undergo the procedu
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