Referrals and Black-White Coronary Heart Disease Treatment Disparities: A Qualitative Study of Primary Care Physician Perspectives

PCPs' referral decisions for CHD treatment are primarily driven by access to specific professional networks and the socioeconomic circumstances of their patients. Nevertheless, PCPs strive to make the best available decisions, leaning into their networks and honoring patient preferences. While PCPs acknowledged existing disparities, they attributed them to patient and system factors rather than provider referral bias. Mitigating disparities will require interventions to improve minority-serving providers' formal and informal connections with high-quality specialists and hospitals, address patient socioeconomic constraints, and train providers to recognize their potential biases and misconceptions.