It is not a new idea, but a recent CNN report (CNN.com, 2009) brings into question again whether there is a bias in the medical community against certain categories of people, most notably African-Americans.
The report, entitled “Does your doctor judge you based on your color?”, describes the experience of a black man named John Reid who went to the emergency room with an infected toe, a result, he was sure, of his diabetes. The doctor who saw him immediately ordered an amputation. Appalled by the decision, he demanded to see the head doctor, who instead ordered a series of IV antibiotics and physical therapy. The second treatment option cost more and took quite a bit longer to complete, but it saved the toe. Reid believes that the original doctor looked down on him because of his race and says, "She just felt like minorities are all the same -- they don't know anything, they're not intelligent, they're not educated.”
Dr. Neil Calman, Reid’s doctor, agrees with his assessment, commenting in his blog that "Racism in health care is a common experience of people of color." However, he also comments that, “[Race] is one very important factor in why people get bad medical care. So is poor education, poverty and lack of insurance."
The report goes on to describe two different studies that demonstrate the importance of race in doctors’ medical practices, mentions that doctors also discriminate against the obese, and concludes it is up to the patient to demand proper care and to seek out a physician who will treat him properly.
Perhaps the clearest part of the author’s argument is the descriptive experience of John Reid himself. Here we have a first-person account of a situation that appears, to all accounts, to support the thesis that race is indeed a major factor in a doctor’s decision on how best to treat a patient. If it were not, would the head doctor have taken the time and effort to review the options to the patient’s satisfaction and thereby put aside accusations of racial bias on his part? While the hospital has refused to comment on the case, leaving us short of supporting evidence to the contrary, the quickness of the original doctor to arrive at so drastic a solution, one that she believed would not be questioned by an “ignorant” patient, would appear to confirm the bias.
Another interesting argument for the bias is the behavior of many older African-Americans, those who grew up in an era of segregation and learned not to question a white “authority figure.” Dr. Cornelius Flowers of Emory University in Atlanta comments that "People who remember those days still consider themselves second-class citizens, and a lot of times they allow people to treat them that way." This does not excuse the behavior, but it does explain why the bias might still actually exist.
Somewhat less convincing are the two case studies the author presents as additional evidence, in large part because the author did not provide adequate attribution for her sources. The first is a 2005 study, which found that black cardiac patients were less likely than whites to receive revascularization, a lifesaving procedure, even though the subjects in both groups were covered by Medicare. The second is a 2007 Harvard study, where researchers showed doctors a history of a man with chest pains; some of the time they matched the history with a photo of a black man, and some of the time with a photo of a white man. The researchers determined that the doctors were more likely to recommend a highly effective drug regimen when they thought the patient was white. Another reason these cases are not as convincing as the author would like is that she did not provide any information about the methods of the studies or their level of statistical significance. Without rigorous and detailed information to support the hypothesis, they become merely anecdotal evidence, and thereby less reliable.
The author briefly mentions an additional medical bias against obese people, but she provides no specific information, and so we cannot make a determination whether this is correct or not.
Race may well be a factor in medical decisions, although I would like to believe that we, as a country, have gotten beyond that mentality. I agree with Dr. Calman in that many African-Americans may not adequately question medical advice or opinions, for many different reasons. Perhaps a rigorous campaign on health awareness targeted at that segment of the population, along with information on how and when to question medical judgment, would be the key to eliminating racial bias in the medical profession.
Works Cited
Cohen, Elizabeth. “Does your doctor judge you based on your color?” CNN.com. 2009. Web. 14 Nov. 2012
