To determine the effect of patient immigrant status on physician trainees’ diabetes treatment decisions. Participants were 140 physician trainees (‘providers’). Providers viewed videos and vignettes of virtual patients differing in immigrant status (born in Mexico or U.S.; other characteristics held constant). Analyses were completed at the group and individual levels. Providers were less likely to refer foreign-born (vs. U.S.-born) patients to endocrinology. Individual-level results showed an almost even split between treatment ratings for foreign-born vs. U.S.-born patients for three decisions (take no action, add oral hypoglycemic agent, add/switch to insulin), explaining why group-level differences for these ratings did not emerge (i.e., they were cancelled out). Physician trainees are less likely to refer foreign-born patients to endocrinology. Half of individual-level decisions were influenced by patient immigrant status, but group-level analyses mask these differences. Systematic treatment differences based on non-relevant factors could lead to adverse outcomes for immigrants.

确定患者移民身份对医师学员糖尿病治疗决策的影响。参与者是 140 名实习医师（“提供者”）。提供者查看了不同移民身份（出生在墨西哥或美国；其他特征保持不变）的虚拟患者的视频和小插曲。分析在组和个人层面完成。提供者不太可能将外国出生（与美国出生）的患者转诊至内分泌科。个人层面的结果显示，在三个决定（不采取行动、添加口服降糖药、添加/改用胰岛素）中，外国出生的患者和美国出生的患者的治疗评分几乎均等，这解释了为什么这些治疗存在群体水平差异评级没有出现（即，它们被取消了）。实习医师不太可能将外国出生的患者转诊至内分泌科。半数个人层面的决定受到患者移民身份的影响，但群体层面的分析掩盖了这些差异。基于非相关因素的系统性治疗差异可能会给移民带来不良后果。