A Tale of Two Studies

Doctors are often seen as some of the most respected members of our society. Since the dawn of civilization and perhaps before, those with the skills and patience to treat the ill, injured and dying are seen as saints, angels and great Samaritans. I am not aware of the details of the Hippocratic Oath, but I doubt that it provides doctors with a convenience of allowing their personal biases to cloud their judgment and diagnoses. Two recent articles, and the scientific studies described within them, may refute common beliefs about the high moral standing of our doctors and the absence of racial biases.

This Washington Post article ("Whites more likely to get ER Narcotics") outlines an apparent racial gap in the prescribing of painkillers. Immediately, I suspected that doctors were not prescribing narcotic based painkillers to African American and other minority patients based on a broad assumption that they believed in a greater likelihood of minority patients to abuse and become addicted to opiate derived medications. The study suggests that not only are doctors less likely to prescribe narcotic painkillers to minority patients, but also that they are less likely to see painkiller abuse in white patients. I am not accusing doctors of being racist or uncompassionate in their prescription practices. Rather I point out this article as a warning for all of us to carefully examine our own racial biases that muddy our actions.

The second article ("Racial disparities persist in US cancer treatment") again highlights the possibility of racial bias and social inequalities of our greater society that have a detrimental effect on the healthcare given to African American patients. Reported by the Reuters News Agency, the American Cancer Society conducted a study focusing on the treatments given to older patients from 1992 to 2002. The study found that African American patients were less likely to receive both possibly beneficial chemotherapy and tumor removing operations. The study does differentiate between doctor’s recommendations and Medicare allowances. Doctors may have recommended such treatment options to be pursued by healthcare providers either denied treatment or patients did not follow up on recommendations. Dr. Otis Brawley, the chief medical officer of the American Cancer Society, stated, “I think individual racism likely accounts for a small amount of it, but not a large amount. What I would refer to as institutional or societal racism accounts for a much larger component of it.” The ACS’s study leader echoed these statements about social inequalities that exist for African Americans in America. Dr. Cary Gross believes that the study “documents the inequities in our society more so than documenting racism among individual providers.” For these two doctors, it is not the individual doctors that need to be examined but rather a more general emphasis on erasing social inequities and providing safeguards to social justice.

Both articles touch on the existence of racism, bias and social injustice in our country. I am not endorsing a wholesale examination of the healthcare industry and doctors for the existence of racial bias. Rather, I believe that these articles should be used to promote awareness that one of our most respected professions – medicine -- is not immune to the prejudice and bias that effect each of us in our daily lives. Even as Dr. Thomas Fischer, an African American doctor in Chicago, speaks about the possibility of bias in the medical field, his words can be understood and used to describe anyone. He states, “If anybody argues they have no social biases that sway clinical practice, they have not been thoughtful about the issue or they're not being honest with themselves.”

J.

Happy Holidays and Coming Soon...

After an extended lull in posts, important issues and interesting topics will take center stage in this new year.

Coming soon...
1) Washington Post reports "Whites more likely to get ER narcotics"
2) Presidential Profiles
3) Election Coverage
4) Baseball Culture & Steroids
5) A look at Friedman's The World is Flat

6) HOPE

I hope your holidays were happy and healthy.  Here is to a Happy New Year and many more after it.