There is a quiet epidemic happening in the medical industry that very few people are talking about. But Blacks all over have, and are currently, experiencing racism in the most life-threatening way when they visit the doctor.
There is an age-old myth, still believed today, that Blacks feel less pain than whites. Half of white medical trainees believe such myths as Black people have thicker skin or less sensitive nerve endings than white people. This belief system manifests in Blacks not being believed when they come in for symptoms of pain. Black people are either not believed, sent home, or given limited resources because their cause of pain is real.
Dr. M. Norman Oliver, Virginia’s health commissioner, studies racial bias in medicine and finds that the centuries-old idea about Blacks and health still exists today.
Several years ago, researchers at the University of Virginia, including Dr. Oliver, probed the beliefs of 222 white medical students and residents and published results in the Proceedings of the National Academy of Science. Half held false physiological beliefs about African Americans. Nearly 60 percent thought their skins were thicker, and 12 percent thought their nerve endings were less sensitive than those of white people.
The medical students and residents who endorsed false beliefs like these were more likely to rate the pain of a Black patient as less severe than that of an otherwise identical white patient and less likely to recommend treating Black patients’ pain.
Other studies show that physicians, white ones in particular, implicitly prefer white patients, falsely viewing them as more intelligent and more likely to follow professional advice.
These belief systems by white doctors directly impact the kinds of treatments that Blacks receive. Because there are racial and ethnic disparities in pain treatment, Blacks quite often get fewer diagnostics and remedies than their white counterparts. One review found such treatment disparities are present across treatment settings. For example, minority patients are rated as having less severe pain, are less likely to receive comprehensive diagnostic and treatment approaches for pain and receive fewer analgesics than white people.
Minority patients are more likely to have their pain underestimated by providers, are less likely to receive opioids as part of their pain management regimen and receive less aggressive pain treatment than white patients. Further, non-white patients seen in emergency departments are 22–30% less likely to receive analgesic medications, 17–30% less likely to receive narcotics, have longer wait times, and are less likely to be admitted compared with white patients.
The results of not being taken seriously put Black patients at risk and impacted the Black community overall. So, what can Blacks do to decrease the confusion and get the quality health care they deserve?
Some of them perceive the problem to come from several areas.
- False beliefs and implicit bias may be driving racial and ethnic disparities in the assessment and treatment of pain.
- Cultural differences among people of diverse racial and ethnic backgrounds lead to differences in pain treatment preferences.
- Racial and ethnic minority patients have worse pain expectations, which may influence pain treatment disparities. However, there is evidence that expectations are malleable and may serve as a good target for intervention.
- Factors including language barriers, lack of access to interpreting services, cultural differences in communication styles, and health literacy all impact patient/provider communication and can lead to poor treatment adherence and outcomes.
Some doctors complain that there is sometimes a language barrier that hampers a doctor’s ability to administer the right treatment. While this notion might have been true in the Deep South, it cannot be used as an excuse to deliver inferior medical treatment.
The trust between Black patients and white doctors can be called into question based on the history of how Blacks were treated in the past by the medical community.
The US Public Health Service (USPHS) Syphilis Study at Tuskegee was conducted between 1932 and 1972 to observe the natural history of untreated syphilis. As part of the study, researchers didn’t collect informed consent from participants and they didn’t offer treatment, even after it was widely available.
Knowledge of the Tuskegee Study resulted in less trust of researchers for 51% of African Americans and 17% of whites. Forty-six percent of African Americans and 34% of whites indicated that their knowledge of the study would affect future research participation decisions. This study sharply impacted the trust that Blacks have for doctors in general.
So how can you protect the ones you love, and yourself, when visiting a white doctor?
The best policy when looking for a primary care physician is to ask friends and family about their experiences when going to the doctor. You can also do your homework and search for recommended physicians in the area.
Quite often. It’s the medical hospital itself that is the problem. Find out if the hospital has a robust position on Diversity, Equity, and Inclusion; or if any Blacks hold positions of responsibility. Today, many medical facilities are doing good work on making sure that the infrastructure of how they administer to Blacks and pain is addressed properly.
