BOSTON – A survey by Medscape, an online publisher of medical news, found that physicians are largely out of touch with their Black and Hispanic patients, who are affected by racism in medicine and in their everyday lives. It was very disturbing that most physicians seem oblivious to the discrimination around them.
According to the poll, which surveyed 2,340 physicians in over 29 specialties, only 22%, or about one in five physicians said they “see racial disparities in the treatment of patients.” It is stunning that these were the results despite widespread evidence during the COVID pandemic that people of color suffered and died disproportionately. Further, public officials acknowledged that it was more difficult for Blacks and Hispanics to access vaccines, especially in the early days of the pandemic.
It has been a long journey for the nation to achieve racial justice and ensure every American’s inalienable right to “life, liberty and the pursuit of happiness.” But in the area of medicine, health disparities, as well as the social determinants of health, demonstrate that structural racism continues to impact patient outcomes.
In 2003, a blue-ribbon panel of the National Academies’ Institute of Medicine released a seminal 764-page report, “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care.” It documents the impact of racism on patient care. A year ago, Stat News, a healthcare publication, published an article, asking: “20 years ago, a landmark report spotlighted systemic racism in medicine. Why has so little changed?”
Moreover, the article noted that “today, the disparities — poorer outcomes and higher death rates for nearly every medical condition the panel examined — and the structural racism underlying them, remain. That grim truth has been made startlingly clear by both the pandemic and by statistics that show Black Americans continue to die up to five years earlier than those who are White.”
Brian Smedley, a member of the Healing ARC Campaign, is quoted in the Stat article, assessing the healthcare environment for people of color. “There hasn’t been a lot of progress in 20 years,” said Smedley, a health equity and policy researcher with the Urban Institute who served as the report’s lead editor. “We are still largely seeing what some would call medical apartheid.”
Stat asked authors of the original report why there has been such little progress and concluded: “The reasons they point to are myriad: Our national discomfort with confronting the long-taboo topic of race remains a roadblock, as does widespread denial among health care providers that they may be part of the problem. Other issues include complacency; a lack of consistent political will to eliminate inequities; health disparities work being elbowed out of the way when other priorities arise; a fragmented health care system that isn’t amenable to universal solutions; and a dearth of quality racial and ethnic data needed to track whether efforts to end disparities are working.”
Indeed, as the Medscape survey reveals, most physicians do not even see racial disparities in health care. Why? The Healing ARC Campaign believes some well-intentioned physicians do not accurately observe or assess their healthcare systems, in part, because of an ignorance about patient experiences of racism in clinics and hospitals and the inequities patients face outside examination rooms.
Still, the Healing ARC Campaign believes there are steps that can address this problem and make our physicians more aware of the people and environment around them. America must:
- Increase the number of physicians who are Black, Indigenous, and other people of color. Based on their lived experiences with racism, they are likely to more clearly understand racism and recognize racism within the healthcare system.
- Encourage physicians to participate in anti-racism training and community-led organizing against racism. When physicians hear directly from patients about their experiences in settings outside the examination room, they are more likely to understand how patients experience racism in medical care.
- Reform our medical education system. Mostly, physicians are not taught to observe and recognize racism, and they are not taught to elicit or acknowledge patients’ experiences of racism. Our medical schools can do a better job of including in their curriculums classes on understanding the impact of racism, health disparities and the social determinants of health.
The Healing ARC Campaign believes these measures can help create a more equitable healthcare system. We work to create environments where hospitals and health centers treat ALL patients with dignity, respect, and fairness. Everyone is entitled to patient-centered and people-centered healthcare, which requires addressing the institutional racism that prevents some, particularly those in communities of color, from receiving equal care.