April 23, 2008
Rahul K. Parikh, M.D. writing at Salon.com:
In 2002, the Institute of Medicine issued a sobering report about health disparities in America. In that report, the IOM challenged assumptions by asking one very hard question: Do doctors treat minority patients differently? Its answer, after reviewing more than 100 studies, was yes, "evidence suggests that bias, prejudice and stereotyping on the part of health care providers may contribute to differences in care."
Dr. Parikh furthers the discussion with a Harvard Medical School study that used computer images to test for implicit racial biases.
In that study researchers recruited internal medicine and emergency medicine residents in the Boston and Atlanta areas. Participants logged into a website and read a clinical vignette while viewing a picture of a black or white person.
The participants were then asked a series of questions regarding the source and treatment of the problem.
In their analysis the Harvard researchers reported no explicit biases by the participants with regards to black and white Americans. However, with regards to implicit biases negative attributes were assigned to blacks more often than whites.
From the Harvard study:
Not surprisingly, most physicians did not admit to any racial biases explicitly. However, on the implicit measures of bias (IATs), most nonblack physicians demonstrated some degree of bias favoring whites over blacks. Participants’ scores on the race preference IAT showed a range of implicit race bias similar to previous experiments on nonphysicians.
Back to Dr. Parikh.
Does this mean that doctors are racist? No. In fact, the discrepancy between explicit and implicit biases in the Harvard study suggests the opposite. But it's clear deeper biases exist, and for several reasons.
First, and most important, doctors are people. There's plenty of evidence that well-intentioned people, whatever their background, possess and demonstrate unconscious negative racial attitudes and stereotypes. Doctors are no different. We share many common conceptions about race in America. We bring those influences, right or wrong, with us to the office.
Dr. Parikh adds that the medical decision making process is often complex and the pressure of time forces the doctor to use shortcuts to arrive at a diagnosis. Stereotypes are just one of those shortcuts.
BONUS: If you are curious about implicit biases there is an online test by the University of Chicago. It looks at your response time in dealing with black and white males with and without a gun. Nicholas Kristof reports his results in this NYTimes.com article.
Posted by Staff at 08:30 AM
Category: Health Disparities