By Janice S. Ellis, Ph.D., Kansas City, MO –
Racial biases in doctor offices while commonplace are being examined for their impact on the delivery and quality of health care services provided minorities.
Understandings, perspectives, biases, and stereotypes about race, whether knowingly or subconsciously have a negative effect on the physician-patient relationship and hence could adversely affect the quality of healthcare provided and corresponding outcomes.
The findings of a study, just released by Johns Hopkins Medicine, provide evidence that racial biases and stereotypical perspectives, whether overt or not, influence what and how a doctor delivers health care. There is also evidence that such prejudicial attitudes could be a direct cause of the disparities among races perpetuated in health care settings across the United States.
Printed in the American Journal of Public Health, the lead researcher in the study, Dr. Lisa Cooper, notes, “If patients have great patient-focused interactions with their doctors, we understand they are more prone to follow through with care, make follow-up appointments and better control diseases including diabetes and depression. This study indicates that unconscious racial attitudes may be standing in the way of favorable interactions to the detriment of patient well-being.”
What’s really compelling about the study’s findings is that it was conducted with patients and primary care physicians who understood each other well and had a relationship over time. The doctors agreed to participate in the study to improve the care provided to African-American patients, and were willing to take pretests to determine racial prejudices and to have subsequent patient visits.
The findings are concerning. Researchers found that white and Asian physicians held more favorable attitudes toward patients that were white than black patients. Black physicians had attitudes that are more neutral.
Researchers also found that there was a direct correlation between how a physician communicated during a visit and the patient’s understanding of the quality of their experience during the visit. Primary care physicians with racial prejudices or stereotypical perspectives tended to speak more than listen during the visit of a black patient; and tended to spend less time addressing the psychological and mental facets of the illness and any treatment challenges that patient might be having.
Black patients because of this, regularly leave feeling they are not involved in decisions or their treatment options and they leave their doctor’s offices feeling disrespected, having lower levels of assurance and trust in their own physician.
The researchers acknowledge that improvement continues to be made in society ordinarily in regards to being open to and accepting of different races and ethnicities. “But we have subconscious bias that we develop from our earliest experiences and are less subject to social pressures,” says Dr. Cooper.
But Johns Hopkins, Dr. Cooper and the team of researchers, the participating primary care physicians, and their patients should be commended for their openness to confront the issue of overt and subliminal racial attitudes and prejudices. Being willing to face those negative realities is the initial step to making essential improvements that may bring about needed change on the part of everyone.
Reaching the best health results, in the end, is what the patient and physician hold in common irrespective of race or ethnicity. Dr. Cooper poignantly captures it when she says, “If we are more aware of how our attitudes are affecting our behaviors, only then can we change what we do and ensure that all of our patients get the best care.”
Many other professions could learn a lesson from this study.
Feature photo credit: minorities.affordablehealthcare.org
Edited and Reprinted with Permission of USAonRace.com