Racial Biases Against Patients: Another Issue To Ponder

Norma, a 57-year-old African-American female, presented to the emergency room with chest wall pain at the community hospital in the small Midwestern city where she resides. After a battery of testing, she was eventually admitted to the telemetry floor for an overnight observation stay. The intended purpose of this article is to further explore the issue of racial biases in healthcare settings.

According to one definition, racial bias means a "pre-formed" negative opinion or attitude toward a group of persons who possess common physical characteristics (McCleary, 2009). Racial bias has been detected in school admissions, hiring practices, promotions, the legal system, the media, financial institutions, and other everyday components of United States society. Keep in mind that persons belonging to any racial-ethnic background may be subject to unfair treatment from those who harbor racial biases.

Racial bias also exists in healthcare, although it happens on a more subconscious level. Research indicates that physicians are major culprits. In a study published in a March issue of the American Journal of Public Health, researchers found that two-thirds of doctors harbored "unconscious" racial biases toward patients (Anderson, 2012). The study showed that the doctors overall had a moderate implicit bias against blacks and a stronger association of whites with compliance (Moyer, 2012).

Research suggests that some nurses and nursing students have subconscious racial biases toward certain patients in the area of pain management. College students and nurses went to greater lengths to ease the pain of members of their own race in a study led by Brian Drwecki, a psychology graduate student at the University of Wisconsin-Madison (Barncard, 2011).

The same study indicated that participants felt more empathy for patients who shared the same racial ethnic background. Despite a vast difference in experience and knowledge-the students had no medical training, while nurses are often directly involved in trying to monitor pain and keep patients comfortable-the two groups showed very similar biases (Barncard, 2011).

Furthermore, the Caucasian students and nurses aggressively managed the pain of Caucasian patients. White participants ordered significantly more pain treatment for white patients, and scored higher on tests measuring the empathy they felt for the patients who received preferential treatment (Barncard, 2011).

How does racial bias affect patients in healthcare settings? Well, it impacts patients negatively and often leads to feelings of mistrust and disrespect. Blacks whose doctors have an unconscious bias also reported reduced trust in their physician, less respectful treatment and a lower likelihood of recommending the physician to a friend (Moyer, 2012).

What are the solutions to racial bias in healthcare? A little empathy will certainly go a long way when dealing with all patients. Healthcare providers and students may want to place themselves in their patients' shoes prior to making decisions regarding care. For instance, in the aforementioned pain treatment study, simply asking the students and nurses to briefly put themselves in their patients' shoes had a drastic effect on their decisions (Barncard, 2011). Moreover, this is another issue where the Golden Rule may be applied: always treat patients in the same way that you would want to be treated.

Racial bias is deeply woven into the fabric of American society; therefore, the issue will not disappear overnight. Together we should do everything humanly possible to strive for equal treatment of all patients who enter the healthcare system as inpatients and outpatients. Even though belief systems do not easily change, each small modification in behavior can cascade into a wave of positively sweeping change.

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Specializes in RN, BSN, CHDN.

Unreal! It always takes my breath away when I read articles like this in 2012.

My question is why is this still happening, what are we not doing to stop this unfair behavior and treatment of people!

I have friends from all walks of life, from all cultures and I see them as friends and people.

My daughter who is 11 is being brought up to look at people as people! Recently she learn't about MLK in school and we talked about life back then and I am proud to say she was shocked and could not believe people were treated this way. I am proud that I am bringing her up correctly. Abby actually cried at the movie 'the help', so I decided stronger movies were not the way forward yet.

I sometimes feel I am a minority because I inform anybody who discusses anything I perceive as a racial in my presence, that I will not listen to this kind of conversation nor will I stay in the room.

The most offensive thing to me is people look at me because I am white and assume it is ok to talk in this manner, they never make the same mistake twice.

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Specializes in Critical Care; Cardiac; Professional Development.

An interesting perspective and thought-provoking. My workplace is extremely diverse and we have a great time with it. We have not had any issues that I know of with nurse bias toward a diverse patient population. But something I have definitely noticed is that the Black patients I have cared for are more suspicious, not just of me, but of the medical profession in general. Some are dramatically warmer and friendlier if they had a Black nurse and are willing to transfer that to me at shift change if they percieve the nurse they had bonded with on days feels confident in me.

As a generality I have noticed the African-American/Black patients we get are far slower to accept a DNR status in a hopeless situation, less likely to question what I am doing or why, less likely to speak up if they have a concern, more likely to simply turn hostile and withdraw. I would love to know how to make this better when it happens and frequently worry there is something about me that caused it. I suspect it has more to do with the history of how African-Americans/Blacks have been treated in our culture than about with me as a person but that doesn't make it feel better when I am working hard to keep them comfortable, secure, educated, in-the-loop and they are dismissive, cold and mistrustful, sometimes out of nowhere when things had been going along fine. It is confusing and can hurt. I wish I had more resources to get through that armor and reach the patient and/or family in those situations. I do think bias can float both ways, but in no way would want to take away from the original point of caregiver bias. It makes me sick to think caregiver bias still exists to be honest.

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Specializes in peds-trach/vent.
are you referring to the bias against white students here? i know when i was in high school and looking into scholarships there were many scholarships that i would have qualified for based on GPA....if i were black.

i never understood why african americans who fought so hard for equality would be okay with colleges allowing a LOWER gpa than what was acceptable for a white person.

i came across scholarships that specifically outlined the gpa needed to be a 3.0 for an african american, but 3.5 for a white student.

i thought, "how unfair and how insulting to the black race."

Apparently, you never heard of the bell curve. that means that if the admitting gpa is 3.0 for blacks and 3.5 for whites, then it must be 3.8 for Asians. you would still apply and hope to get it.

Also studies show that schools in white neighborhoods, have better funding, better books, better teachers, so therefore better gpa's. thats where blacks should feel some insult. thats where the chief disparity lies. its in who is getting the quality education.:)

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Also studies show that schools in white neighborhoods, have better funding, better books, better teachers, so therefore better gpa's. thats where blacks should feel some insult. thats where the chief disparity lies. its in who is getting the quality education.:)

But what if you are white and growing up in a black/hispanic neighborhood??

I dealt with the same crappy educational system they did, but I still have to have the higher GPA?

It really yanks my chain when people assume all white people are well-off.

It's a stereotype.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

It really yanks my chain when people assume all white people are well-off.

It's a stereotype.

Racial stereotypes are hurtful, but they are a routine aspect of living in the US. I cannot write a personal check in most places of business because people assume there's no money in the account, when I actually have a five-figure balance. After certain people and vendors speak to me for a few minutes, some will comment that I do not speak like the rest of 'those people.'

So, I agree. Whether the person being prejudged is black, white, Latino, Asian, or American Indian, racial stereotyping is wrong on so many levels.

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Specializes in peds-trach/vent.
But what if you are white and growing up in a black/hispanic neighborhood??

I dealt with the same crappy educational system they did, but I still have to have the higher GPA?

It really yanks my chain when people assume all white people are well-off.

It's a stereotype.

i did not yank your chain. you caused it to yank on your own. if you read my entire quote, you will notice the word "studies". and you would have realized at that moment that i was not stating something based on assumption or stereotype, i was basing it on a statistic. and i'm not saying or assuming that all whites are well-off. ive treated many people, whites incuded, from all various socioeconomic backgrounds.

no. i will not provide a link for proof. google it and do your own research. but i will say this... if brown vs board ofeducation was decided in 1954, then why are children still being bused in 2012. why are some politicians still fighting for school vouchers in 2012 to send less fortunate kids to better school districts. according to you, it would be because they have the same stereotypes as me. who knows, maybe their assumptions, like mine, are based on studies too.:)

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Racism is a real thing. It is sad to hear and know that it exist in the healthcare system.

I feel everyone is a human being. We all are here to live and die. We all have good and bad times. None of use are better than the other. Therefore, we all deserve the same treatment no matter where we are especially in healthcare I feel.

One of my personal friends is a black nurse practicioner and she personally experienced racism. She was working as a educator and supervising a nursing student who was white. The patient and family made rude comments to the instructor simply due to her race (stating the nursing student was much more competent than my friend, with some other negative comments made).

Though we are professionals, we are also humans. Therefore, we make errors. Though this is a huge error, it's reality. If I personally witnessed it, I would have to pull the person to a private area and explain what I saw and make them aware of the situation.

Everyone deserves to be treated the same. The Golden Rule is the best rule to follow and have people ask themself would they like to be treated like they are treating people.

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I definitely have had experiences with racist nurses and doctors. I am mixed (black and white) but I look more black or latina. My sister looks more white than anything. Yet, we both had different experiences at this certain hospital where we live. Basically, she was invited to some committee to speak about improvement of patient care and I was harassed, insulted, and ignored at this hospital. I definitely was not treated with any respect or dignity but my sister was.

Now, I was very compliant, and my sister was not. I am a very easy patient , my sister is very difficult.

Another experience I had at the ER, I had double vision and eye deviation because of an acne medication. I went to the ER and the doctor that I saw was such an a*** very rude and desrepectful. The first thing he said to me was, "What can I do for you" I said I have no idea I'm not a doctor, all I know is that I can't see my eyes are moving all around etc... I told him maybe a CAT scan? Now, I should not have to tell the doctor what he needs to do for me I obviously have no idea what needs to be done. Then he said," Now, when I do that are you gonna be all set, you will be satisfied with a CAT scan?"

I was ****** leaving this hospital. I complained to the department of health in that state and they did nothing at all.

Turns out, my eye doctor said I needed a spinal tap, had too much fluid in my head and there are meds for it. My eye doctor was disgusted when I told him about my experience.

So, thankfully, I went to a neurologist and got the spinal tap done. I'm better now thank god and thanks to my eye doctor.

I sent my eye doctor an edible arrangment bouquet to thank him for being such a great doctor.

Thanks to him, my eyes are back to normal now. This happened a couple of years ago.

This has not been the only bad experience I've had with doctors/medical professionals I've had a lot which is one of the reasons why I want to become a nurse. I want to change some of the behavior I witnessed as a patient and as a CNA.

I 've heard horror stories from other people in my area and know a couple of people who are suing a couple of hospitals. I tell people I can't be the only one complaing there needs to be more than one person with a problem in order for things to change.

I am a spiritual person and I believe in Karma. People , like that doctor I spoke about, have a hard path ahead of them and they will experience what they caused.

That's why when I was a CNA, I made sure I was very kind, patient, and understanding. I showed compassion because you never know when you will be in a vunerable position in life and you are totally dependent on others to care for you.

Let's hope they treat you well and not like this doctor/hospital treated me.

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i did not yank your chain. you caused it to yank on your own. if you read my entire quote, you will notice the word "studies". and you would have realized at that moment that i was not stating something based on assumption or stereotype, i was basing it on a statistic. and i'm not saying or assuming that all whites are well-off. ive treated many people, whites incuded, from all various socioeconomic backgrounds. no. i will not provide a link for proof. google it and do your own research. but i will say this... if brown vs board ofeducation was decided in 1954, then why are children still being bused in 2012. why are some politicians still fighting for school vouchers in 2012 to send less fortunate kids to better school districts. according to you, it would be because they have the same stereotypes as me. who knows, maybe their assumptions, like mine, are based on studies too.:)

I read your whole post.

I stated my dislike for the stereotype.

I understand what you said about studies.

However, while it may be shown that white students have access to better education and, thus, higher GPAs, it is not true for all.

So, while we paint with a broad brush-- based on studies-- there are those, such as me, who fall between the cracks.

Why does it have to be a race issue?Poor people have poor educational resources and it's true no matter what color you are.

So why put a color on it?

I'm not barking at you.

I'm not shooting the messenger.

I saw your post and it made me think about something I don't like.

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