Updated Sunday, Nov. 30 at 10:07 p.m.
Race plays a lamentably larger role today than in the past in how doctors treat patients, said Lundy Braun, professor of medical science and Africana studies, at a talk Wednesday night. Many health disparities among individuals of different ethnicities have been dismissed as genetic in nature, when in reality, they derive from factors like income, history and politics, she added.
Braun was one of three panelists in a forum titled “Doctors Reading Race: How Conceptions of Race Shape Medical Care,” hosted by the student group chapter of Health Leads, a national nonprofit group that connects people with health care resources. Around 70 people showed up to the half-full MacMillan 117.
The panel started with individual statements from each of the panelists, followed by a question-and-answer session. Panelists gave their perspectives on the issues surrounding race and medicine and their personal experiences with relevant problems, such as misdiagnoses due to racial biases.
Race is one of the most salient attributes that a doctor uses to classify a patient’s illness and medical history, Braun said. For example, values obtained from tests for lung function are often corrected to a “normal value” that is the average value of white patients. But in reality, most problems cannot be attributed to a person’s race or genetic history, she added.
“The person in front of you is not a representative of a type,” she said.
The forum aimed to foster conversation on some of the underlying structural problems in medicine, said Leila Blatt ’15, an organizer of the event and a campus coordinator for Health Leads. The relationship between race and medicine is currently a hot topic in the media and certain areas of academia, and many sources of information about race and medicine only explore the issue at a superficial level, she added.
Nearly all medical encounters cross socioeconomic lines, since doctors tend to be wealthier than their patients, said M. Barton Laws, assistant professor of health services, policy and practice at the School of Public Health and another panelist. Adding differences in ethnicity, language and culture to physician-patient interactions can “compound the problem,” he added.
Medical students are often not taught about the structural factors involved in dealings between doctors and patients, said Gopika Krishna ’13 MD’17, the third panelist. Contrary to what she has learned in her medical school classes, “race has never been something that is genetically defined,” she said. Physicians are paid to know the biology of a person’s body, which often means they have a dearth of knowledge about the history and context of racial bias in medicine, she added.
When Laws worked in a clinic near Boston, he noticed striking differences in the ways individuals of different ethnicities were treated. Latino patients with bone fractures were less likely to get opioid pain medication than white patients were, and doctors inquired about the sexual history of Latina women but not of white women, he said.
Many medical care facilities and clinics have attempted to combat discrimination in patient care by implementing mandatory “cultural competency” training, which is a method of teaching how to be sympathetic in medicine, Braun said. But many of these programs have become “bureaucratic enterprises” and have lost sight of their intended purpose, she added.
The forum was also meant to urge students involved in Health Leads to reflect on how they can improve their work within the health care system, Blatt said. “We as advocates see a lot of awful things that (are said) in clinics,” she said.
During the question-and-answer session, one undergrad asked how best to balance the need to think about a patient as an individual with the need to consider the structural factors at play.
Doctors can overcome this tension by thoroughly interviewing their patients to better understand their backgrounds, Braun said in response. “A sickness isn’t always going to show up on a medical exam.”
A previous version of this article misidentified M. Barton Laws’ title. He is an assistant professor of health services, policy and practice at the School of Public Health, not the Alpert Medical School. The article also previously incorrectly described Health Leads. It is a national nonprofit that connects people with health care resources, not advocates for equality in health care resources. The Herald regrets the errors.
Updated Sunday, Nov. 30 at 10:07 p.m.