Race, Class, and Worsened Healthcare Outcomes
We rely on doctors to provide us the best possible care. Sometimes, they do not live up to that responsibility because of a misdiagnosis, inappropriate medication, or a host of other preventable missteps.
One troubling cause of these lapses may be a doctor’s subtle bias when it comes to race and social class. Researchers have already shown that many people hold a strong, unconscious prejudice (called implicit bias) against people of color and people of lower socioeconomic status, even if on a conscious level, they wouldn’t endorse that prejudice.
Doctors, like any other human beings, are likely to have implicit biases. They very likely are not overtly racist or classist. Nevertheless, it’s already known that being a person of color or poor is independently correlated to worse health outcomes. So the practical, medical questions are these: does the race or socio-economic status of patients affect the care their doctors provide? Is bias to blame for poor prognoses? In some cases, the answer could be a question of life and death.
The Relationship Between Bias and Treatment
The results of various studies on race bias and treatment are by no means cut-and-dried. They reveal a complicated relationship between race, class, and doctor-patient interactions. Some studies show only that doctors do indeed hold strong implicit (and sometimes even explicit) racial and socioeconomic biases, usually with a preference for white, rich patients.
According to the Journal of the American Medical Association, 69 percent of first-year medical students implicitly preferred white patients, and 86 percent preferred upper-class patients. Though these results are troubling in and of themselves, that study did not find that they affected doctors’ decision making in any significant way.
Other studies, however, went further in concluding that patients’ race and status did have a tangible effect on the treatment they received. For example, take the case of cardiovascular disease. Black patients are less likely than white patients to receive treatment for heart disease, so some researchers at Harvard Medical School set to find out why. They used thrombolysis, which is a treatment for coronary artery disease, as a test case. In the experiment, it turned out that doctors with strong implicit anti-black biases were less likely to prescribe thrombolysis, even when they believed that thrombolysis is generally an effective treatment. That indicates that doctors frequently declined to provide black patients with an effective course of treatment.
A similar study found that the higher a doctor’s implicit racial bias, the lower the clinical rating he or she was likely to receive from black and Latino patients. In other words, not knowing about the bias, these minority patients said that their doctors were not providing them with a good level of care. The link between care and social class has not been as well-studied, but certain treatment biases have emerged, such as a decreased likelihood of ordering MRIs for patients of lower socio-economic classes. As more studies establish the link between unconscious bias and quality of healthcare, the medical profession must surely do some soul-searching and find ways to guarantee quality care for all.
The Medical Malpractice attorneys of Philadelphia’s The Colleran Firm are dedicated to finding justice for victims of medical negligence and bias. If you believe you have a case, contact our firm today. Our experienced attorneys handle cases of severe malpractice and are ready to fight for you.