If African-American patients do have access, "often they want to see African-American orthopedists," Dr. White says, because they place their trust in black doctors more readily than white ones.
But, depending on the geography, they may not be easily available.
About 75% of physicians identified themselves as white, while 4% were African-American and 5.3% Hispanic, in a 2008 Health Tracking Physician Survey by the Center for Studying Health System Change.
Meanwhile, some patients with insurance don't know that orthopedic surgeries are covered, so they don't consider that option, Dr. White says. Undergoing the surgery without insurance coverage would be prohibitively expensive.
"Access and health insurance are the two biggest obstacles to arthritis treatment," Dr. White says.
With undocumented Hispanics, immigration fears may prevent them from seeking a doctor's care at county facilities, making them especially at risk for advanced disease, doctors say. Family responsibilities keep them away from doctors too.
"Women who are the mainstays of their family units don't have time for surgery," Dr. White says.
For example, knee surgery is a "major operation," with full recovery taking 6-12 months, Dr. Harrington says. Patients must be healthy enough to undergo physical therapy before and after the operation, and be able to undergo anesthesia. Patients return to most activities in 2-3 months.
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