One of my favorite
shows on television is comedian John Oliver’s ‘Last Week Tonight’. I enjoy his
political satire show for many reasons. Thanks to its platform on HBO John
Oliver is able to discuss his true feelings about the news over the past week,
and specific opinions about politicians in the news. His show is informative
and hilarious, but what I enjoy the most is the second half of the show when he
reports on a specific story or issue. On his August 18th episode of this year,
he devoted the second part of his show to investigating gender and racial bias
in medicine. This subject is especially important to me and was both upsetting
and informative to watch. The segment begins with interview clips from white
women and women of color who experienced biases when they sought medical
treatment. The biases they were faced with inhibited their care, and for some
resulted in adverse outcomes. These women are not alone in their experience.
A study published in
2014 in the Journal of the American Board of Family Medicine presented
internal and family medicine physicians with vignettes of patients with
osteoarthritis. The vignettes were identical except for patient race, one
Caucasian and one African American. Participants reported that they believed
the white patients were being more medically cooperative than the African
American ones1. Another study published in 2016 in the Proceedings
of the National Academy of Sciences in the United States, found that a
substantial number of the participants surveyed, which included white
lay-people, medical students, and residents, held false beliefs about
biological differences between blacks and whites. Furthermore, the study found
that these false beliefs predict racial bias in pain perception and treatment
recommendations2. These studies demonstrate the real implications
bias has on patients and the healthcare they receive.
Race and gender
biases in healthcare are not relics of the past - they are very much present
and perpetuated in our current healthcare system. I believe that it is the
provider’s obligation to themselves and their patients to take the time to
assess their own inherent biases. From this, one can learn how to recognize
bias in themselves and others, and work to provide specialized and bias-free care
for patients. In theory, this will lead to providing the best care possible for
the patient, and hopefully a positive experience in the healthcare setting.
This in turn promotes follow-up and access to preventive healthcare measures.
Additionally, I believe it is important to teach medical students early in
their medical careers about implicit biases and the effects of gender and
racial biases in medicine. If these concepts are broken down early on, it will
decrease perpetuation, but it will also leave ample time for students to
further investigate and discuss this important aspect of healthcare.
Camille Campion DUCOM 2020
Articles Cited:
- Oliver M.N.., K.M. Wells, J.A. Joy-Gaba, et al. Do physicians’ implicit views of African Americans affect clinical decision making?. JABFM.2014, 27(2)177-188.
- Hoffman K.M., S. Trawalter, J. R. Axt, and M. N. Oliver. Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. PNAS. 2016. 113(16)4296-4301.
I highly recommend viewing the segment, please
find the link below:
Inherent bias survey by Project Implicit
developed by Harvard University: