Thursday, July 23, 2009

Medical treatment based on the color of your skin


Racism may not be obvious, but it can present itself in very subtle ways. CNN has a story titled, "Does your doctor judge you based on your color?"

I'd hate to think that doctors are racist, but the title implies exactly that point. Are doctors racist? Here's a quote from the story:
Reid, who is African-American (and who also has diabetes), firmly believes that if he'd been a white man, the junior doctor wouldn't have been so quick to order the cheaper and more drastic solution over his objections... Reid says he thinks the young doctor assumed he wasn't smart enough to think through a medical decision.
CNN contacted the hospital but Montefiore Medical Center refused to discuss his case.

"It's absolutely proven through studies that a black man and a white man going to the hospital with the same complaint will be treated differently," Dr. Neil Calman, a family physician and president of the Institute for Family Health in New York, said. Where's the proof, right?
  • A 2005 study found African-American cardiac patients were less likely than whites to receive a lifesaving procedure called revascularization, where doctors restore the flow of oxygen to the heart.
  • A 2007 study involving clinical case vignettes found that doctors were more likely to recommend lifesaving drugs when they thought the patient was white than when they thought the patient was black.
Doctors are humans and they are prone to bias. It's a part of human nature. In some cases, doctors may make an extra effort to treat minorities with extra care. Is that fair for non-minorities? At the end of the day, we all want equal care. We don't want favoritism, but it happens because we're all human. It's not just about race, either. According to CNN, a study from researchers at the New York University School of Medicine found more than 40 percent of the doctors surveyed had a negative reaction to obese people. Here we go again. Some people find the word "obese" to be offensive, and they may sue you if you call them that.

11 comments:

  1. orical of open amsJuly 25, 2009 at 9:09 PM

    Only my dermatologist bugs me about skin color.

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  2. I am Indian American and I find that particularly when it comes to kids, white doctors do not seem to be too bothered - at laeat the quality of care I get for my kids is sometimes shoddier and non-caring as compared to how some of the doctors treat white kids. Again this happens abou 30-40% of the time.

    But once I let them know subtly that my circumstances are perhaps on par with them financially and education-wise, I see an instant change in their attitude - they seem to realie they ae talking to some one that is their peer and are more careful. I guess doctors in US will be more careful once much of doctors' work is offshored!

    I am not sure how this country, my country too now, tolerates this condescending attitude of doctors. I attend a lot of parties and functions at Doctors' homes and I see a lot of referrals, checkups that virtually amount to cheating and fraud.. the amount of back-scratching in medicine is almost as bad as in politics.

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  3. I would like to see more physicians chime in here -

    The vast majority or people enter a medical profession to help others, regardless of race. I can never recall any physician I've worked with ever saying "I don't want to treat that patient because he/she is XYZ race". There are far easier ways to make money than being a physician.

    Additionally, how convenient that Elizabeth Cohen (the article's author) dumps this information just after tensions are flaring over the Louis Gates/Obama scenario. She also conveniently omitted the FACT that different races are more prone to certain disease processes and diseases in general. Even though Elizabeth Cohen is NOT a physician, her Public Health degree should have taught her this basic fact. If she was truly an objective reporter, she would cite statistics released by the National Institutes of Health describing how certain races simply have higher rates of certain diseases and health histories. Oh....that's right, she needs to get publicity for herself before her new BOOK RELEASE!!!

    Once again folks, this is simply an example of the MEDIA inciting RACE just for the sake of popularity and selling stories. Can't we get beyond this?

    Chuck in Denver

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  4. Blah! Blah! Blah! Go to Canada and wait in line.

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  5. As a physician I can tell you that race has never played a part in the care that I deliver. Socioeconomic status might, not because of financial issues but because of follow up issues. Having worked at a county hospital it is incredible the amount of patients that fail their appointments. So if follow up is a concern then the options for care can be drastically different. Also the case of Mr. Reid sounds like it was a resident who came in and saw him and decided what was best and was overrided by her attending. This isn't that uncommon and doesn't really have to do with the race of the patient. It also isn't uncommon for a diabetic patient with a toe infection that likely was in the bone to have it amputated, antibiotics in this case are frequently unsuccessful. And the reason that the hospital can't comment on the case is because of HIPPA, so it would be against the law for them to comment. The way that the media often paints hospitals for not commenting on patients cases is ridiculous because for them to do so would be negligent. This was a poorly written article by CNN in my opinion and was very subjective. It did not discuss the reasons that African American patients might not have been offered revascularization as often as Caucasians besides race, or what the difference in rates actually was. I have a hard time believing that it was due to race but I guess it is possible.

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  6. I dually remember a question like this in my Sociobiology course about "Racist doctors?" and whether it was good or bad for a doctor to treat according to one's ethnicity. I personally think that when we center on a person's race for treatment opposed to the validity of the treatment and care provided for "any" individual we are robbing ourselves of the greatest good. "That" being the ultimate pursuit of all medicinal, Scientific and fact based truths toward the greater good of man-kind and the pursuit of knowledge. In no way is it right to center your beliefs, thoughts,knowledge or teachings around a person's skin color. No matter how much one thinks it will change the outcome, we were not put here to feel that man-kinds' existence relies upon such measures, so to force the issue agitates any validating beliefs in the bonds we all share as human beings equal in our pursuits and pleasures in this life and beyond.

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  7. Racism: The great talent Michael Jackson picked a black doctor Conrad Murray and he injected him with medication that killed him and I'm sure he trusted that black doctor with his life and look what happened.I arrest my case.
    Someboby's going to read this.

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  8. My God, where do I have to go to watch a newsstation without a political agenda?

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  9. Physicians are just people and no more or less prone to racism than anyone else. Yet I doubt that skin color is what motivates physicians to treat one patient differently than another. The motivating factor is money. And, let's face it, minorities tend to have either no or inferior health insurance.

    Modern physicians care only about how much money they can get from our insurance companies, which is one of the primary reasons for the escalating cost of health care. Having a medical background myself, I generally have a good idea of what is wrong with me when I see a physician and, if I don't, I know that only some simple differential diagnosis involving one or two lab test is all that is needed. Yet, I cannot remember the last time a physician actually applied this first principle of medical practice. Rather, they order a barrage of expensive and unnecessary tests and go through at least two incorrect diagnoses before coming to the conclusion I brought into the office with me. The result is that my insurance company must pay thousands of dollars more than it should to get to the point of a treatment plan. To make matters worse, the treatment plan itself is usually inappropriate, too expensive, and, all too often, ineffective.

    The health care system in this country is hopelessly broken and I have no faith that politicians are going to be able to fix it. They, too, follow the money and the health care lobbies have pockets full of cash to spend on legislation that will ultimately benefit only them. Rather than facing this reality (and several others), we allow ourselves to be distracted about whether or not minorities are receiving inferior care.

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  10. To respond to the last anonymous. Your physicians are probably not ordering tests to make money. They do not have any ownership in the lab so don't benefit at all by ordering tests and it actually may hurt them if they order tests because many of the insurance companies have contracts with physicians that can in a small way reward them for doing less. The real reason that they're probably ordering tests if they are really "unnecessary" is to cover their ass so that if litigation became an issue they could have potentially ruled out some of the serious things that are in the differential diagnosis. I agree this isn't a good way to practice medicine but the fear of litigation is very strong. I can't even imagine how many CT scans of the head are done everyday in the ER for headaches that are completely unnecessary. But our society has decided to reward its citizens like a lottery system with huge payouts that just encourage more frivolous law suits and hurt the ones that are actually reasonable.

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  11. I believe doctors discriminate against skin color and body size I am a Black American over weight woman I fell and broke my wrist. I went to the er at one of the hospitals in Springfield,Ohio and the P.A. examined me had my arm x-rayed and toled me it was a very badly sprained ligiment. I continued to have severe pain and returned to the same hospitil was re-x-rayed examined by a different P.A. and was told and shown the x-ray that I had a displaced broken wrist. The insurance had nothing to do with my treatment the first P.A. was a young caucasain thin man who had more interest in the nurses than me a heavy set black woman. I have very good insurance and he had no way of knowing what type of insurance I had because that information is taken at the registration desk, befor the patients get to the exam rooms.

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