When was the last time anybody enthusiastically anticipated a doctor’s appointment? The doctor’s office is typically not a particularly agreeable place to be. However, this unpleasantness does not entirely stem from health-related concerns and anxieties that plague patients’ thoughts. Healthcare settings are fundamentally social settings –  involving a significant dimension of communication and interpersonal interaction. With that in mind, it is essential to question what it is about interacting with medical professionals that frequently elicits a reaction of discomfort, rather than serving to quiet patients’ worries as it expectedly would.

According to generalized research studies, healthcare professionals in the USA unconsciously display the same levels of implicit bias as the general population. As shown by modern research [1], these complex biases manifest as both differences in the dynamics of patient-doctor interactions as well as statistically significant disparities in the quality and type of healthcare treatment received by individuals of different races and socioeconomic statuses, genders, weight levels, and ages. The alarming concept that African American, Hispanic, female, overweight, and elderly patients could be receiving possibly inadequate care, unconsciously warped by implicit biases, raises concerns about the state of contemporary healthcare. This fact furthermore highlights a contributing factor to commonplace patient hesitance to obtain proper medical attention, in the interest of avoiding dissatisfying and problematic relations with medical experts.

Biases, unsurprisingly, do not claim only practicing medical professionals as their victims; medical students are guilty of prejudice as well. “New Johns Hopkins research shows that medical students — just like the general American population — may have unconscious if not overt preferences for white people, but this innate bias does not appear to translate into different or lesser health care of other races.” [2] This research reveals the foreseeable yet still perturbing origins of implicit bias growing in concealment as early as medical school. Furthermore, it shines a spotlight on the lack of intersectionality between medical and humanities research, despite modern leaps in interdisciplinary academia. The research cited prior in this article displays the fact that, in reality, differential treatment is indeed provided to individuals of specific races (and other identities). Had the Johns Hopkins research involved a substantial socio-psychological and perhaps longitudinal component of inquiry, it might have traced the mechanism through which biases gain traction and begin to manifest in treatment choices, as clearly happens when students progress from medical school to clinical practice (as shown by the aforementioned research [1]).

At what points throughout the medical education process, or even perhaps earlier, are medical students subconsciously developing these perilous latent attitudes that later become influential in their treatment of patients? This is a question that forthcoming research must tackle relentlessly, making use of the existing literature of medical humanities in an integrative, multidisciplinary approach involving the collaboration of professionals from diverse fields. Biases and preconceptions should arguably be eradicated from their roots on a wider social scale, but this must start somewhere, and the healthcare bureaucracy is as appropriate of a starting point as any other. In fact, one could argue that eliminating inequity and injustice in medical care must be the preliminary step preceding large-scale societal upheaval. Individuals’ lives are at stake in the medical industry. The most rudimentary consideration that can be shown to people, before progressing to more consequential and extensively meaningful undertakings, is respect for their being.

References

  1. Sabin, 2009; Green, 2007; Cooper, 2012; Drwekci, 2011; Todd, 1993; Todd, 2000; Borkhoff, 2008; Chapman, 2001; Schwartz, 2003; Madan, 2001 and 2006; Reuben, 1995; Uncapher, 2000
  2. Hopkins Medicine, “Looking for the Roots of Racial Bias in Delivery of Health Care”

Posted by Joe Rizkallah

Joe is a freshman studying Molecular & Cellular Biology. A member of HMR’s Medical Humanities team, he is interested in exploring the complex interface between sociocultural factors and clinical practice, as well as diverse topics relating to bioethics, medical philosophy and the nuanced boundaries between humanities and sciences (or lack thereof). He is also involved in numerous on-campus organizations, including Alpha Phi Omega and Refuel Our Future, and he is currently conducting research at the Viral Oncology lab of the Johns Hopkins medical campus. Outside of class, he enjoys swimming, badminton, and exploring the nooks and crannies of Baltimore.