Personal biases of physicians and others in healthcare continue to affect patients of all kinds. These can be prejudices about specific diseases or treatments or prejudices about the patients themselves.
Pain management is an area where racial differences have been widely documented but not fully understood. A new study published in PNAS indicates that erroneous beliefs about racial differences lead white doctors and medical students to make less appropriate pain treatment recommendations. In short, black patients may be deficient in pain management if their doctors believe that black bodies are inherently stronger than white bodies.
To study the phenomenon of racial bias in pain treatment, the researchers conducted two studies. They first examined the beliefs of white people who were not medical professionals to determine basic biases about pain perception for people from different backgrounds. They found that white adults with no medical training subscribe to at least some false beliefs about biological differences from black people, including the erroneous belief that blood clots at different rates for people of different races.
They also found that among white participants, there was a racial difference in participants’ perceptions of others’ pain, particularly among those who had other misconceptions about the biological differences between races. This bias was fueled by the pervasive belief that a black body is inherently stronger and a white body inherently weaker.
After identifying these racial biases in nonmedical professionals, the researchers went on to investigate whether they affected evaluations of pain perception when black patients are treated by white physicians.
When white medical students and medical assistants were asked similar questions, the researchers got the same results. For medical professionals who held many false beliefs about biological differences between the races, the racial bias in pain perception reappeared — they rated black patients’ pain as “less painful” compared to white patients.
This bias was carried over into their treatment recommendations. Doctors and medical students who held more false beliefs about biological racial differences also recommended less appropriate treatment for black patients, likely because of their misperceptions of these patients’ pain experiences.
In contrast, when white doctors and medical students had a more realistic view of biological differences, they showed the reverse effect. These participants more often rated the pain of white patients as ‘less painful’ than that of black patients. However, these participants did not show any bias in their treatment recommendations.
We know that there is a great racial disparity in pain treatment, both in terms of patient treatment and outcomes. This article shows that these differences may be due to fanciful beliefs about biological differences between people of different racial groups and that these beliefs persist even among highly trained medical professionals.
As such, the paper illustrates the need for diversity awareness training in medical education. It could help doctors examine their own biases and ensure that patients of all races receive appropriate treatment.
PNAS2016. DOI: 10.1073/pnas.1516047113, (About DOIs).