How the country of education affects migrant doctors' acceptance among their patients

Abstract

BACKGROUND: Countries such as the UK are becoming increasingly dependent on foreign-schooled doctors for supplying medical services. This leads to well-known patient-doctor discordance issues, such as lower patient trust in foreign doctors. The role of doctor education in this issue is not well understood, leading us to pose the question: To which extent does the place where a doctor was educated, as opposed to the place where they were born, predict patients' attitudes and behavioural intentions towards that doctor? In addition, we investigate if patients' intentions towards a foreign doctor can be influenced by providing information about three well-known social attributes that may be affected by doctor education, i.e., competence, sociability, and morality. METHOD: Five vignette studies measured the response of majority group members (White, UK or NL-born participants), assuming the role of patients, to migrant doctors who were either educated abroad or in the country of destination (total N = 1181). RESULTS: A doctor's birthplace and a doctor's place of education both impacted patients' acceptance of that doctor. Training in the UK, as opposed to a foreign country, was associated with higher levels of competence. However, when presented with negative information about the doctor's competence, sociability, and especially morality, patients' acceptance of that doctor plummeted. CONCLUSIONS: Providing foreign doctors with training in their country of destination may improve those doctors' acceptance amongst patients. Preventing negative word of mouth about a doctor's moral conduct, more so than about their sociability or competence, should furthermore be an important educational goal.