In response to the #BlackLivesMatter movement and the #WhiteCoats4BlackLives “die-ins” at 70 American medical schools, three leading health experts are speaking out about the need for physicians to address racial bias in patient care and the preference of some physicians for white patients.
Writing in the February 2015 issue of the New England Journal of Medicine, David A. Ansell, M.D., M.P.H., and Edwin K. McDonald, M.D., from the Department of Internal Medicine at Rush University Medical Center, and Mary Bassett, M.D., commissioner of the New York City Department of Health and Mental Hygiene, call for changes in the way physicians are trained, greater attention to the recruitment of black medical students and medical school faculty, and closer examination of bias in care.
“There is evidence that doctors hold stereotypes based on patients’ race that can influence their clinical decisions,” Ansell and McDonald point out. “Although explicit race bias is rare among physicians, an unconscious preference for whites as compared with blacks is commonly revealed on tests of implicit bias.”
And while Ansell and McDonald acknowledge that many different factors contribute to poor health in black Americans, they cite several studies that show “minority patients received fewer recommended treatments for diseases ranging from AIDS to cancer to heart disease.”
“And racial gaps in health care outcomes have persisted,” they said. “For example, gaps in blood pressure, cholesterol and glycated hemoglobin control between black and white members of Medicare health maintenance organizations were found throughout the period 2006 to 2011.”
Bassett calls for broader advocacy by health care providers. “Some physicians and trainees may choose to participate in peaceful demonstrations; some may write editorials or lead “teach-ins”; others may engage their representatives to demand change in law, policy and practice,” she said. “Rightfully or not, medical professionals often have a societal status that gives our voices greater credibility.”
How to Get the Best Care
Of course, millions of well-meaning physicians practice without any bias at all. But here are steps you can take to make sure you are receiving the highest quality of care:
- If it feels wrong, make a change. Don’t stick with a doctor who makes you uncomfortable or fails to treat you with the proper respect. If your instincts tell you your doctor does not have your best interests at heart, you are probably right, so find a new provider.
- Become an educated patient. Learn all that you can about your family health history, your personal health risks and the top treatments for any condition you may have. If your doctor does not keep you up to date on the latest treatments, demand a second opinion from another specialist of your choosing.
- Ask the right questions. The federal Agency for Health Care Research and Health Care exists to protect, evaluate and improve the quality of health care Americans receive. Read the agency’s list of important questions for patients, and review its educational videos for patients to learn how to handle your next doctor visit.