Intended for healthcare professionals

Letters Ethnic group and medical care

What about doctor factors?

BMJ 2009; 339 doi: (Published 05 October 2009) Cite this as: BMJ 2009;339:b4060
  1. Claire L Morgan, researcher1,
  2. Hendrik J Beerstecher, GP principal1
  1. 1Sittingbourne, Kent ME10 4JA
  1. clmorgan{at}

    Mead and Roland report differences in patients’ evaluation of medical care that are related to the patient’s ethnic group.1 They may not have corrected for a possible confounder, the doctor’s characteristics.

    We examined the relation between patients’ ethnic group and the percentage of UK graduate doctors at practice level using data on country of primary qualification in the 2004 general practice research database and patient declared ethnic group in the 2006-7 GP patient survey.2 3 We summed the Asian and mixed Asian subgroups and the black and mixed black subgroups in the survey to reflect the groups in Mead and Roland’s study. We were able to match UK graduate and ethnicity data for 8047 of the 8386 (96%) English practices in the 2006-7 GP patient survey.

    We found a positive relation between patient declared white British status and the percentage of UK graduates in the practice (r=0.35, P<0.001). We found a negative relation between the proportion of UK graduates in the practice and the proportion of patients of Asian or black ethnic group (r=−0.35 and r=−0.23 respectively, P<0.001).

    Asian and black ethnic patients seemed to be being cared for by practices with a higher proportion of foreign medical graduates, and they are likely to be experiencing a different primary care service in England.


    Cite this as: BMJ 2009;339:b4060


    • Competing interests: None declared.


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