Strenghtening Patient-Provider Relationships By Reducing Health Care Disparities

Dr. Monica Peek’s interest in public health and health disparities began long before she obtained her medical and public health degrees. Her great-great grandparents were slaves, her parents were raised during Jim Crow laws, and while she grew up in suburban Tennessee, she had family in “very poor, very black” Cleveland.

“Underrepresented minority physicians tend to come from families that are much closer to a working class population. I knew I was going to be interested in looking at larger system level questions of how we can help population health in vulnerable communities,” Peek said.

She has rounded out an extensive academic and professional career to support her research passion: eliminating the distrust minority patients have of the health care system and their providers, with a focus on diabetes care and breast-cancer screening education for African American patients.

There is a long-standing distrust between underrepresented minorities and their health care providers, which Peek chalks up to a tumultuous American legacy of minority maltreatment, from slavery to segregated health systems to unethical experimentation on vulnerable populations.

“The underlying thing I’m really interested in is patient-provider communication and patient empowerment,” said Peek. “And how people who have typically been disenfranchised from the medical system can be supported to take control over their health so they can have better health outcomes and reduce health disparities.”

According to an article, “A Study of National Physician Organizations’ Efforts to Reduce Racial and Ethnic Health Disparities in the United States,” that Peek cowrote for Academic Medicine, health care disparities have been attributed to racial and ethnic minorities having unequal access to comprehensive, high-quality health care, inadequate emphasis on health promotion and prevention, and aspects of the patient-provider relationship.

Peek, who is a founding Faculty Fellow of the Bucksbaum Institute for Clinical Excellence at the University of Chicago, researches such disparities through the South Side Diabetes Collaborative alongside Dr. Marshall Chin. Launched in 2008, the Collaborative educates and enables African American diabetes patients to take control of their health. Aside from collecting quantitative data, Peek and her team ask questions about patient-provider communications, trust, diabetes knowledge and history, and their confidence in managing it.

“It doesn’t matter if you know diabetes is bad for you, if you don’t think you can do anything about it then you’re not going to try to do anything about it,“ Peek said. “To that end, we collect measures of self-efficacy before, during, and up to six months after the program completion.”

Their efforts are paying off. Early results have indicated better self care in some patients, better-controlled glucose levels, and the connection of more than 4,000 patients to a medical home, according to Dr. Peek’s article in Health Affairs.

Peek also examines provider relationships and whether they are representative of a more diverse patient care community.

“I’m trying to find out reasons where there are differences in health outcomes for a diverse patient population versus non-Hispanic white patients. There’s research that has found that African American patients are more satisfied and have better quality-of-care measures when their provider looks like them,” Peek said. “The relationship with minority patients have with their doctors is central and key to a lot of things that happen subsequently regarding their health outcomes and confidence.”