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Racial bias from white physicians

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southernhybrid

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I've read and known about this for a long time. I thought about adding it to the thread about MCAT scores but decided it might be better to start a new thread. Maybe it belongs in the social science area or added to the other thread. If it's moved, I have no objection.

https://pmc.ncbi.nlm.nih.gov/articles/PMC4843483/

The present work examines beliefs associated with racial bias in pain management, a critical health care domain with well-documented racial disparities. Specifically, this work reveals that a substantial number of white laypeople and medical students and residents hold false beliefs about biological differences between blacks and whites and demonstrates that these beliefs predict racial bias in pain perception and treatment recommendation accuracy. It also provides the first evidence that racial bias in pain perception is associated with racial bias in pain treatment recommendations. Taken together, this work provides evidence that false beliefs about biological differences between blacks and whites continue to shape the way we perceive and treat black people—they are associated with racial disparities in pain assessment and treatment recommendations.

Keywords: racial bias, pain perception, health care disparities, pain treatment
Black Americans are systematically undertreated for pain relative to white Americans. We examine whether this racial bias is related to false beliefs about biological differences between blacks and whites (e.g., “black people’s skin is thicker than white people’s skin”). Study 1 documented these beliefs among white laypersons and revealed that participants who more strongly endorsed false beliefs about biological differences reported lower pain ratings for a black (vs. white) target. Study 2 extended these findings to the medical context and found that half of a sample of white medical students and residents endorsed these beliefs. Moreover, participants who endorsed these beliefs rated the black (vs. white) patient’s pain as lower and made less accurate treatment recommendations. Participants who did not endorse these beliefs rated the black (vs. white) patient’s pain as higher, but showed no bias in treatment recommendations. These findings suggest that individuals with at least some medical training hold and may use false beliefs about biological differences between blacks and whites to inform medical judgments, which may contribute to racial disparities in pain assessment and treatment.

A young man goes to the doctor complaining of severe pain in his back. He expects and trusts that a medical expert, his physician, will assess his pain and prescribe the appropriate treatment to reduce his suffering. After all, a primary goal of health care is to reduce pain and suffering. Whether he receives the standard of care that he expects, however, is likely contingent on his race/ethnicity. Prior research suggests that if he is black, then his pain will likely be underestimated and undertreated compared with if he is white (1–10).
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As a matter of fact, I have a very close Black friend who has suffered with chronic pain for years, yet the same doctor who originally approved narcotic pain relievers for me, has kept her on gabapentin for years until she recently asked him to wean her off of it, as it never decreased her pain. I've read that this is not unusual and while I hate to think that this doctor might have some racial bias, it does seem to be somewhat common among white physicians to treat their black patients differently, especially when it comes to pain. Plus, sometimes people aren't even aware of their racial bias.

I've also read that black folks, especially black males often don't trust white doctors. I can understand why so that is another reason why more black students who have decent MCATS and grades need to be approved for medical school. One doesn't have to have the highest MCAT score to become a good doctor, as that as already been documented in the other thread. One needs to be willing to learn, to have compassion, to be open minded, caring and keep up with the latest medical science to be a good doctor and perhaps one of the most important things is to treat all of your patients equally, regardless of their race, age, gender etc. The first thing Iearned when studying nursing was never to judge my patients, and to provide good care to all of them. That has always stayed with me, and I try to apply it to others as much as I am able, now that I'm retired.

One more thing. Just because the over all population is still mostly white, I live in a small city where the black population is about 51% and the white population is 49%, so shouldn't we have more black doctors and NPs than the over all population in the US? Some black doctors aren't very good and some white doctors are also incompetent, but it has nothing to do with their race. We also have a sprinkling lot Asian and Hispanic folks in my city but like my neighborhood, it's mostly a mix of black nd white. And, the last time I checked ATL was still majority black, but I doubt the medical community in ATL is mostly black.
 
It has long been known that there is a certain amount of racial bias, dare I say critical bias, of white physicians towards black people. I think many white physicians do not recognize it in themselves. And it runs the gamut of both physical and mental health. Both pain and anxiety or fear are downplayed more for black patients than whites.
 
I only have anecdotal evidence here. My Dad had emergency surgery. It isn't clear, but the surgery knocked him out. Recovery was a bother as he had almost no stamina. Went to his doctor (new doctor) and they really didn't believe him. I was aghast as my Dad never complained at all. In fact, he was walking about at work with a gall bladder that was gangrenous! The doctor didn't budge.

My Dad had surgery for cancer and the doctor asked about the pain threshold and my Dad said about an 8. The doctor wasn't certain about it. In a new role as advocate, I told them, if he says it is an 8, it is probably an 8. Doctor listened to me, and they got out the good stuff.

With my Grandmother, my Aunt, former NICU nurse, always felt it was important to humanize our grandmother (her mother-in-law), to help keep her an older human instead of just an elderly patient.

So in general, my experience, as a white guy is that having an advocate is very important, particularly with doctors you have never seen before.
 
Imagine a young medical doctor. He(always male) grew up in an upper middle class family. His father sat in an office all day long. The closest he came to manual labor was pushing a lawn mower. His first real contact with manual labor is the men who have spent their entire working life on their feet, lifting heavy things. Their bodies have scars on the skin and the bone. To his newly trained mind, this patient should be in great pain to the point of disability, yet he sits there as if it's just another Tuesday.

Modern medical training teaches him to evaluate a symptom and identify a cause. What to do when a cause is observed without the symptom is rarely addressed. An individual may have a high pain threshold and when others in their socio-economic group mirror this, it's easy for our young doctor to see a pattern. His experience with muscle aches and pains is limited to high school varsity Lacrosse.

If his medical training had included a few philosophy electives, he might have run across Stoicism. This could give some insight to his blue collar patients who see life as something to be endured because there's no other path. Complaining about pain is pointless. It's not accepted as an excuse on the job. "Taking it easy" means the rent will be late.

An anecdote: Many years ago in my car days, I spent a year as body shop foreman. There was a black man who came around each week to collect scrap body parts. He was probably in his sixties, at least 30 years older than me. Auto body sheet metal is low grade scrap and takes up a lot of space for the weight. It's the low end of the market. He bent down to get his fingers under a Camry hood(about 60 pounds) and hefts it on top of the pile in the bed of his truck. He turned to me and said, "I just can't work like I used too since that prostate surgery." In the same situation, I would have been home watching Days of Our Lives.

Race is a distinct line, so it's easy to assume it is the line. It probably is in many cases, but it's a blurry line.
 
Playball40 said:
Probably not relevant, but I'm finding just about ALL doctors these days are dismissing "pain" because they are afraid to prescribe ANY narcotics.
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Heh.
Try hospice. So liberating…
Feeling a twinge? Have some more XYZ opiate or NSAID!
It greatly simplifies things to stop considering long term effects of drugs, and the hospice paradigm lets you do that.
Of course you’ll die, but you’ll die anyway. And it probably won’t be today or tomorrow, regardless of whether you choose to endure pain or muffle it out of existence with otherwise harmful drugs. So bring on the painkillers!

Of course I’m being bitterly facetious, and only offer my current circumstance as excuse.
Honestly, I take Ibu and acetaminophen and do so fairly regularly before exercise. But that’s just in order to realize the REAL painkillers - endorphins. Those don’t just mitigate pain, they make you feel GOOD!
After 60+ years of unrelenting pursuit of miracle drugs, it’s down to the ones my body provides when encouraged to do so.
 
Playball40 said:
Probably not relevant, but I'm finding just about ALL doctors these days are dismissing "pain" because they are afraid to prescribe ANY narcotics.
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I think it depends on where you live. It's not that hard to get narcotic pain relievers in the area of Georgia where I live, at least if you're white, not sure if you're black. But, when I was living in Indy briefly, they acted as if Rx. pain meds were heroin. According to my sister, it's the same way in NJ. We do have a regulation in Ga. that you must be seen by a provider at least every three months and have a drug test done every three months. My providers require at least a virtual visit monthly, which I find a waste of time for me and them.

The truth is that narcotic pain relievers are much safer compared to NSAIDS for most older adults. One of my former patients nearly died from a Rx. NSAID, but was later put on a narcotic after her recovery from the severe GI bleed.
 
Playball40 said:
Definitely
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Forgot one that's not typically thought about, age bias. Medical's can be both offender and victim. I typically avoid old surgeons, and any medical that is overtly religious.
 
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Bronzeage said:
Imagine a young medical doctor. He(always male) grew up in an upper middle class family. His father sat in an office all day long. The closest he came to manual labor was pushing a lawn mower. His first real contact with manual labor is the men who have spent their entire working life on their feet, lifting heavy things. Their bodies have scars on the skin and the bone. To his newly trained mind, this patient should be in great pain to the point of disability, yet he sits there as if it's just another Tuesday.

Modern medical training teaches him to evaluate a symptom and identify a cause. What to do when a cause is observed without the symptom is rarely addressed. An individual may have a high pain threshold and when others in their socio-economic group mirror this, it's easy for our young doctor to see a pattern. His experience with muscle aches and pains is limited to high school varsity Lacrosse.

If his medical training had included a few philosophy electives, he might have run across Stoicism. This could give some insight to his blue collar patients who see life as something to be endured because there's no other path. Complaining about pain is pointless. It's not accepted as an excuse on the job. "Taking it easy" means the rent will be late.

An anecdote: Many years ago in my car days, I spent a year as body shop foreman. There was a black man who came around each week to collect scrap body parts. He was probably in his sixties, at least 30 years older than me. Auto body sheet metal is low grade scrap and takes up a lot of space for the weight. It's the low end of the market. He bent down to get his fingers under a Camry hood(about 60 pounds) and hefts it on top of the pile in the bed of his truck. He turned to me and said, "I just can't work like I used too since that prostate surgery." In the same situation, I would have been home watching Days of Our Lives.

Race is a distinct line, so it's easy to assume it is the line. It probably is in many cases, but it's a blurry line.
Click to expand...
Every watch I stood in the navy I did so in pain, lower back pain. It wouldn't be until my last few month before retirement after 23 years that I would find out this pain was due to degenerative discs. There was no way I was going to complain about this any time sooner. "Doc, doc, I can't stand watch. My back hurts." If there is one constant in the navy it is watchstanding. You are not staying in the navy if you can't stand watch. You'd have a better chance of staying in the navy if you couldn't go to sea. So I stoically stood my watch, with a 9mm on my hip that magically increased in weight with each passing hour. I tend to get all kinds of resolute when I consider my options.
This is why you'll never hear me weep for the plight of the black man. At least he's got a particular white demographic on his side. I don't even get that. But I don't need it, do I? I'm privileged, right?
 
Fuck me sideways I am looking foreward to the usual cunts dropping their 2 cents in this thread. Weak piss ants that they are.
 
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