A U.S. study in the Journal of Clinical Oncology has analyzed that racial bias on the part of a doctor can result in inadequate medical treatment and communication for black cancer patients. Researchers analyzed video-recorded discussions between oncologists and African-American patients and discovered that biased doctors spent less time with their patients and patients had a harder time remembering the contents of their conversation. Author Louis A. Penner of the Karmanos Cancer Institute Detroit, Michigan said people generally have some level of racial bias, whether implicit or not, and doctors are no exception.
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The new study was made to see if implicit bias contributes to cancer treatment disparities. Before observations, 18 non-black medical oncologists took implicit racial bias tests. The doctors, mostly men, had small to moderate levels of implicit racial bias. Several weeks later, researchers recorded the interactions between the oncologists and 112 of their new black patients at cancer hospitals in Detroit, noting the time of the conversations, levels of distress and trust, and their thoughts of the recommended treatment. On average, oncologists and patients spent 30 minutes together. In that time period, oncologists spoke four times as much as the patients. Oncologists with higher levels of implicit racial bias had shorter interactions and patients reviewed their interactions as “less patient-centered and supportive.” In addition, cancer patients had a harder time remembering what was discussed and had lower levels of confidence in the recommended treatments.
Adam T. Hirsh of Indiana University-Purdue University Indianapolis stated that this is compelling evidence that implicit racial biases on the side of providers affects how they interact with patients. He told Reuters Health that although implicit racial bias has more of an influence on the process of care, we should be cautious about concluding they have no effect on outcomes. Hirsh also said that the irony is that implicit bias most likely affects behavior when people are experiencing “cognitive overload,” absorbing a lot of information at once and having to make decisions in uncertain situations. This is very much mirrors an oncology appointment.
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Penner stated that patients can detect implicit bias and that, in turn, depletes the confidence in both the physician and their recommended course of treatment. While reducing bias in cancer interactions will not eliminate disparities, it can play a crucial role. He stated that there is evidence that a medical student’s exposure to diversity in medical school affects their levels of implicit bias. Penner also believes that physicians need more training in communicating with all types of patients as ease in communication will lessen the likelihood that implicit bias will affect verbal/nonverbal behaviors when interacting with black patients.
Luis Gay is a Junior attending the University of San Francisco, pursuing a Biology degree. His aspirations include serving underrepresented communities through medicine and advocacy. He is a Social Media Assistant at Cancer InCytes Magazine.
Doyle, Kathryn. 24June2016. “Racially biased cancer doctors spend less time with black patients”. Reuters. [Acessed 18 July 2016]