A recent report from The New York Times highlights how doctors describe Black patients in medical records. Reporters looked closely at two large studies that analyzed notes doctors would leave behind on patients' records about whether they followed medical advice.
Researchers found that certain terms are more likely to appear on Black patients' medical records compared to patients of other races. Lines saying a patient is "noncompliant," "nonadherent," or "refused" treatment or changes, suggest patients are uncooperative and may show troublesome behaviors.
What makes this problematic is that a patient's medical record is a doctor's first impression of them, according to Dr. Gracie Himmelstein, one of the study's authors. Seeing negative descriptors of Black patients will leave doctors with undue assumptions about them before they even start treating them.
"In medicine, we tend to label people in derogatory ways when we don’t truly ‘see’ them — when we don’t know them or understand them,” Dr. Dean Schillinger told reporters. He is the director of the Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center. "The process of labeling provides a convenient shortcut that leads some physicians to blame the patient for their illnesses," Schillinger explained.
Dr. Michael Sun, the lead author of the other study, says medical teams should assess a patient's background rather than dismiss them as unmotivated or disengaged. Obstacles to seeking help or getting treatment include transportation, financial barriers, illiteracy, and other issues.
“It’s not so much whether you should never use these words, but why are we applying these words with so much more frequency to Black patients?" Sun told NYT. “Do we really believe Black patients are truly not compliant, so many more times than white patients?”
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