Does racial bias by doctors hurt black patients’ ability to get adequate pain management?

patientThe answer is “yes,” according to a new study which  finds that medical students hold “fantastical” views about biological differences between blacks and whites, and this may result in blacks receiving less help in managing pain.

Another new piece of research finds that doctors communicate with black patients worse than whites about important end-of-life decisions.

Although minority patients long have suspected uneven quality of care, the issue has grown as demographic trends change America’s population, and the nation seeks to improve its health system to make it more effective, efficient, and less costly.

Black medical students have grown increasingly vocal about racial disparities in health care. One major health care foundation has found that Latinos and African Americans confront inequities in preventive care critical to staying healthier and reducing later needs for medical treatment:  Its 2016 national data showed that 82 percent of whites had a dedicated healthcare provider, while this was true for 76 percent of blacks and only 59 percent of Hispanics.

When it comes to a concrete, direct, and distressing aspect of patient care, the new University of Virginia study raises tough questions about medical students’ racial bias and ignorance, and how that translates into pain treatment. The study of white medical students found many of them believed in “outlandish” ideas that blacks had thicker skin and less sensitive nerve endings than whites. They rated African Americans pain as less than whites, making less appropriate pain-care treatment recommendations, as a result.

Meantime, the medical students–almost 300 of them studied, in total–also failed to recognize true biological differences between races, such as that blacks are more susceptible to heart disease than are whites.

Although physician bias may result in African Americans suffering more pain than is appropriate, it also may be a factor as to why blacks have played a smaller role in the U.S. epidemic of abuse of opioid prescription painkillers. As the Centers for Disease Control and Prevention (CDC) points out about opioids’ abuse: “Overdose rates were higher among non-Hispanic whites and American Indian or Alaskan Natives, compared to non-Hispanic blacks and Hispanics.”

Poor rapport about critical end of life care

Racial bias also may affect blacks and the care they receive at the end of their lives, a recent, small study found. It looked at almost three-dozen hospital-based physicians and their capacity to grasp verbal and nonverbal clues from patients about end of life care.

The doctors, the study found, established poorer rapport with African American patients. The researchers said this may help to explain why, although most Americans say they prefer to die at home, “Black patients are more likely than white patients to die in the intensive care unit [while receiving] life-sustaining treatments.”

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