by Randy Dotinga, Healthday Reporter
But study doesn't look at real-life cases.
(HealthDay)—A new survey finds that hospital doctors don't treat patients differently because of race or income level, even though it detected unconscious bias in some clinicians.
Researchers asked more than 200 doctors at Johns Hopkins Hospital in Baltimore how they would respond to various hypothetical situations involving white and black patients, and rich and poor patients.
The results "raise questions and provide more of an impetus to think about what plays out in real-world settings," said Dr. Marshall Chin, professor of Healthcare Ethics at the University of Chicago, who wasn't involved in the study.
However, the fictional approach limits the study's value because it didn't assess actual patient care, he added.
"We can't conclude that this applies to real patients," Chin said.
At issue: Do physicians treat patients differently based on their race, income levels and so on? The researchers said there are decades of evidence that certain groups do receive different levels of care.
"We know from hundreds of studies that minority patients, particularly African-American patients, are less likely to get medical services than white patients," said Dr. John Ayanian, director of the Institute for Healthcare Policy and Innovation at the University of Michigan.
In 2010, for example, a study in the journal Circulation found that black patients in the United States were 3 percent to 16 percent less likely to receive recommended stroke care, such as clot-busting drugs. Ayanian was co-author of a study published December 2014 in the New England Journal of Medicine that found that black seniors have more trouble controlling their blood pressure, cholesterol and blood sugar than whites, a possible reason why blacks don't live as long.
However, it's difficult for researchers to pinpoint how many of these differences are due to prejudice in the medical system versus lifestyle and other decisions by individuals.
In the new study, researchers presented doctors with stories about fictional patients and asked how they'd deal with them. The narratives were designed to catch unconscious bias.
A total of 215 clinicians—surgeons, fellows, interns, residents and other kinds of physicians—took the 20-minute survey in 2011 and 2012. All received $25 gift cards for participating.
The study reports that most participants showed signs of bias based on race and social class.
But the researchers said they found little sign that bias affected decisions about patient care, and no evidence that it disrupted assessments of patients.
The findings are "reassuring," said Ayanian. However, "it's important to look at actual decisions, and that's certainly more challenging to study than hypothetical cases," he added.
"In order to understand whether our health care system is making progress, we need to look closely at the care that actual patients receive, and understand the barriers that patients face from their perspective," Ayanian said.
Another health disparities researcher, Stanford University's Dr. Kim Rhoads, said this study "neither proves nor debunks the argument that racism may be at play in health care."
However, the research does show "that physicians are really no different than the general population with respect to carrying some bias by race and social class," added Rhoads, an assistant professor of surgery.
Chin said future research could videotape the actual care provided by physicians. "Within the first 30 seconds, people forget they're being videotaped," he said.
What could researchers find? "There are very few cases where it's outright racism," Chin said. "I think it's more subtle things."
In some cases, he added, the health system itself may be unintentionally biased against certain patients.
The study appears online March 18 in the journal JAMA Surgery.
Explore further: Unconscious race and social class biases appear unassociated with clinical decisions
More information: For more about health disparities, try the U.S. National Library of Medicine.
Copyright © 2015 HealthDay. All rights reserved.
Medical Xpress on facebook
Related Stories
Unconscious race and social class biases appear unassociated with clinical decisions
5 hours ago
While unconscious race and social class biases were present in most trauma and acute-care clinicians surveyed about patient care management in a series of clinical vignettes, those biases were not associated with clinical ...
Race/ethnicity sometimes associated with overuse of medical care
Mar 06, 2015
Racial and ethnic disparities in the receipt of health care (typically referring to minorities not receiving needed care) are well known. A recent review in the journal Milbank Memorial Quarterly has now found that while ...
Certain factors influence whether cancer patients involve family members in treatment decisions
Feb 23, 2015
Family members often play an important role in providing care for patients with cancer, but which patients are more or less likely to involve family members in decisions regarding their care is not well known. A new study ...
Minority physicians care for a majority of underserved patients in the US
Dec 30, 2013
Black, Hispanic and Asian physicians play an outsized role in the care of disadvantaged patients nationally. Patients who have low incomes, are from racial and ethnic minority backgrounds, have Medicaid insurance, or who ...
Physician-controlled decisions in cancer care linked to lower quality rating
Feb 12, 2015
Patients who described physician-controlled decisions about their cancer care versus shared decision-making were less likely to report receiving excellent quality of care, according to a study published online by JAMA On ...
Recommended for you
Bloomberg, Gates launch anti-tobacco industry fund
20 minutes ago
Billionaire philanthropists Michael Bloomberg and Bill Gates launched a joint fund in Abu Dhabi Wednesday to help developing countries pass tobacco-control laws in their legal battle with industry giants.
Is too much artificial light at night making us sick?
22 minutes ago
Modern life, with its preponderance of inadequate exposure to natural light during the day and overexposure to artificial light at night, is not conducive to the body's natural sleep/wake cycle.
Finding support for surgery on Facebook
56 minutes ago
For many, Facebook connects friends, family, and others with common interests. Despite the popularity of social networking sites like Facebook, scientists are only beginning to learn how they affect human interaction.
Health care law paperwork costs small businesses thousands
2 hours ago
Complying with the health care law is costing small businesses thousands of dollars that they didn't have to spend before the new regulations went into effect.
Changes in health care delivery essential to combat chronic disease
3 hours ago
Chronic disease accounts for 7 of every 10 deaths in the United States and more than 75% of total health care costs. Among people 65 years old and older, over 92% suffer from one or more chronic diseases. ...
When it comes to health care, young gay men are falling through the cracks
5 hours ago
Emerging adulthood is a complex time for anyone. It ranges from late adolescence to one's mid-twenties – ages when we are seeking to establish our identities in social contexts, and transition from childhood ...
User comments
Please sign in to add a comment. Registration is free, and takes less than a minute. Read more
Click here to reset your password.
Sign in to get notified via email when new comments are made.
© Medical Xpress 2011-2014, Science X network
by Randy Dotinga, Healthday Reporter
But study doesn't look at real-life cases.
(HealthDay)—A new survey finds that hospital doctors don't treat patients differently because of race or income level, even though it detected unconscious bias in some clinicians.
Researchers asked more than 200 doctors at Johns Hopkins Hospital in Baltimore how they would respond to various hypothetical situations involving white and black patients, and rich and poor patients.
The results "raise questions and provide more of an impetus to think about what plays out in real-world settings," said Dr. Marshall Chin, professor of Healthcare Ethics at the University of Chicago, who wasn't involved in the study.
However, the fictional approach limits the study's value because it didn't assess actual patient care, he added.
"We can't conclude that this applies to real patients," Chin said.
At issue: Do physicians treat patients differently based on their race, income levels and so on? The researchers said there are decades of evidence that certain groups do receive different levels of care.
"We know from hundreds of studies that minority patients, particularly African-American patients, are less likely to get medical services than white patients," said Dr. John Ayanian, director of the Institute for Healthcare Policy and Innovation at the University of Michigan.
In 2010, for example, a study in the journal Circulation found that black patients in the United States were 3 percent to 16 percent less likely to receive recommended stroke care, such as clot-busting drugs. Ayanian was co-author of a study published December 2014 in the New England Journal of Medicine that found that black seniors have more trouble controlling their blood pressure, cholesterol and blood sugar than whites, a possible reason why blacks don't live as long.
However, it's difficult for researchers to pinpoint how many of these differences are due to prejudice in the medical system versus lifestyle and other decisions by individuals.
In the new study, researchers presented doctors with stories about fictional patients and asked how they'd deal with them. The narratives were designed to catch unconscious bias.
A total of 215 clinicians—surgeons, fellows, interns, residents and other kinds of physicians—took the 20-minute survey in 2011 and 2012. All received $25 gift cards for participating.
The study reports that most participants showed signs of bias based on race and social class.
But the researchers said they found little sign that bias affected decisions about patient care, and no evidence that it disrupted assessments of patients.
The findings are "reassuring," said Ayanian. However, "it's important to look at actual decisions, and that's certainly more challenging to study than hypothetical cases," he added.
"In order to understand whether our health care system is making progress, we need to look closely at the care that actual patients receive, and understand the barriers that patients face from their perspective," Ayanian said.
Another health disparities researcher, Stanford University's Dr. Kim Rhoads, said this study "neither proves nor debunks the argument that racism may be at play in health care."
However, the research does show "that physicians are really no different than the general population with respect to carrying some bias by race and social class," added Rhoads, an assistant professor of surgery.
Chin said future research could videotape the actual care provided by physicians. "Within the first 30 seconds, people forget they're being videotaped," he said.
What could researchers find? "There are very few cases where it's outright racism," Chin said. "I think it's more subtle things."
In some cases, he added, the health system itself may be unintentionally biased against certain patients.
The study appears online March 18 in the journal JAMA Surgery.
Explore further: Unconscious race and social class biases appear unassociated with clinical decisions
More information: For more about health disparities, try the U.S. National Library of Medicine.
Copyright © 2015 HealthDay. All rights reserved.
Medical Xpress on facebook
Related Stories
Unconscious race and social class biases appear unassociated with clinical decisions
5 hours ago
While unconscious race and social class biases were present in most trauma and acute-care clinicians surveyed about patient care management in a series of clinical vignettes, those biases were not associated with clinical ...
Race/ethnicity sometimes associated with overuse of medical care
Mar 06, 2015
Racial and ethnic disparities in the receipt of health care (typically referring to minorities not receiving needed care) are well known. A recent review in the journal Milbank Memorial Quarterly has now found that while ...
Certain factors influence whether cancer patients involve family members in treatment decisions
Feb 23, 2015
Family members often play an important role in providing care for patients with cancer, but which patients are more or less likely to involve family members in decisions regarding their care is not well known. A new study ...
Minority physicians care for a majority of underserved patients in the US
Dec 30, 2013
Black, Hispanic and Asian physicians play an outsized role in the care of disadvantaged patients nationally. Patients who have low incomes, are from racial and ethnic minority backgrounds, have Medicaid insurance, or who ...
Physician-controlled decisions in cancer care linked to lower quality rating
Feb 12, 2015
Patients who described physician-controlled decisions about their cancer care versus shared decision-making were less likely to report receiving excellent quality of care, according to a study published online by JAMA On ...
Recommended for you
Bloomberg, Gates launch anti-tobacco industry fund
20 minutes ago
Billionaire philanthropists Michael Bloomberg and Bill Gates launched a joint fund in Abu Dhabi Wednesday to help developing countries pass tobacco-control laws in their legal battle with industry giants.
Is too much artificial light at night making us sick?
22 minutes ago
Modern life, with its preponderance of inadequate exposure to natural light during the day and overexposure to artificial light at night, is not conducive to the body's natural sleep/wake cycle.
Finding support for surgery on Facebook
56 minutes ago
For many, Facebook connects friends, family, and others with common interests. Despite the popularity of social networking sites like Facebook, scientists are only beginning to learn how they affect human interaction.
Health care law paperwork costs small businesses thousands
2 hours ago
Complying with the health care law is costing small businesses thousands of dollars that they didn't have to spend before the new regulations went into effect.
Changes in health care delivery essential to combat chronic disease
3 hours ago
Chronic disease accounts for 7 of every 10 deaths in the United States and more than 75% of total health care costs. Among people 65 years old and older, over 92% suffer from one or more chronic diseases. ...
When it comes to health care, young gay men are falling through the cracks
5 hours ago
Emerging adulthood is a complex time for anyone. It ranges from late adolescence to one's mid-twenties – ages when we are seeking to establish our identities in social contexts, and transition from childhood ...
User comments
Please sign in to add a comment. Registration is free, and takes less than a minute. Read more
Click here
to reset your password.
Sign in to get notified via email when new comments are made.
© Medical Xpress 2011-2014, Science X network
0 comments:
Post a Comment