Inconsistencies Between Racial and Ethnic Groups’ Medical Care
Most of us have felt frustration at a doctor’s office at one time or another. You may have felt that your visit was too quick to get the full picture of your situation. Or, you may feel that the doctor handed you a prescription to avoid investigating further.
What if your disappointment came from improper medical care? And what if the reason for your substandard treatment was because your doctor looks different from you?
That’s the reality for a lot of minority groups, even this day in age. We hear the statistics every now and again – African-American women are more likely to die in childbirth, or more recently, African-Americans are more likely to die from COVID-19. What’s going on with racial disparities in medical care?
In this post, we’ll go through a few examples of how implicit bias plays out in medicine, and what to do if you suspect your doctor’s biases are influencing your medical care.
Doctors are more likely to under-treat pain in non-white patients.
Pain management varies greatly between racial and ethnic groups. Non-white patients are prescribed pain medication less often than white patients for the same levels of pain, and old misconceptions like “black people have fewer nerve endings” still persist to this day. Researchers found that white study participants more easily recognized pain on white faces than on African-American faces, which could lead to assessment errors if it plays out the same way in a clinical setting.
Your race could alter your chance of having major surgery.
Race was found to be a risk factor for amputation, even after controlling for illness severity, disability, and complexity of cases. In one study, African American patients underwent major amputation more often than white and Hispanic patients after open lower extremity bypass surgery.
Being African-American or Latina woman means you are more likely to have a caesarean birth than white women.
Doctors with high levels of implicit bias may be less supportive.
Researchers found that oncologists with high implicit bias provided less support and spent less time per visit with African-American cancer patients than with white patients. This reduced their patients’ confidence in treatment plans and it also created the sense that it would be more difficult to follow treatment instructions.
Additionally, word choice may be different when your doctor has high levels of bias, which may affect the doctor-patient relationship and treatment plans.
Doctors who rated higher for implicit bias were more likely to use anxiety-related words like “worried,” “afraid,” and “nervous” when interacting with African-American patients, which the researchers attributed to the doctors’ own anxiety coming out in conversation. High-bias doctors were also more likely to use words like “we,” “us,” and “our” when discussing conditions with patients, which another study has associated with the perception of social dominance. An example of the difference…
Notice the difference?
What to do if you think your race is influencing your doctor.
Overall, doctors want to be effective at their jobs, and ultimately, they want their patients to get better. If race comes into play, they may not be aware that they harbor biases that affect how they treat patients. If you suspect race is influencing your plan of care, remember: you have agency over your own body, always. There are things you can do to get the most effective medical care for you.
- Bring a trusted friend or family member with you. Your condition could make you feel tired or weak, or your ability to think clearly may be compromised for the time being. Just the stress of having an illness or injury alone could make important discussions difficult. Take someone with you to your appointments who can make your preferences known.
- Research your condition. Studies show medical web apps aren’t always accurate, but if you pull a handful of trusted sources related to your symptoms, you can use what you find to open up an informed discussion with your doctor. Write down thoughtful questions and see how the discussion unfolds.
- Ask for a second opinion. Implicit bias isn’t a “you have it or you don’t” situation. It’s a spectrum – each doctor will have different levels of implicit bias. Stack that on top of the uniqueness of each case, and the individuality of each patient, and you have lots of room for different treatment plans to emerge on the same set of symptoms. Different doctors may arrive at different conclusions. There’s nothing wrong with finding out how another doctor would treat your condition, and using that information to decide how to proceed.
- Call out racial biases when you notice them. It doesn’t have to be accusatory or combative. You can say something along the lines of, “sometimes medical professionals do not notice that race is a factor in [situation].” Or, “I’ve read that more African-Americans receive this treatment than the other option. Can you explain how we arrived at this care plan?” Sometimes, a little awareness can make a big difference.
Lastly, it's important to take your health into your own hands. So much of a healthy lifestyle begins with knowledge. Shaka Smith is a black fitness model, actor, and lawyer, and vegan. His way of sharing his passion for health and fitness is through the Fit Club podcast, aimed at getting helpful wellness information in front of the black and minority populations. Watch this for a glimpse into who Shaka is and what his podcast offers...