Published On November 25, 2015
IT’S NO SECRET THAT THIS COUNTRY HAS A LONG AND TROUBLE HISTORY with racial inequality. Though significant progress has been made in crafting policies that prohibit overt discrimination, many more subtle forms of prejudice continue, including within the health care system. Minority patients tend to receive less pain medication for the exact same fracture, for instance, and though white women are more likely to have breast cancer, African American women are 40 percent more likely to die from the disease. Meanwhile, minorities remain underrepresented in medical school classes and on hospital staffs, even though the overall U.S. population has become increasingly diverse over the past several decades.
In an address at the annual meeting of the Association of American Medical Colleges (AAMC) on November 8, 2015, Peter Slavin, who just stepped down as chairman of the AAMC and president of Massachusetts General Hospital, discussed the many inequities that still plague the U.S. health care system. “Here in America – half a century after the Civil Rights Act became law – the strongest predictor of someone’s health status is the color of that person’s skin,” Slavin said.
“Even if you control for income, education and health insurance, patients of color are still not receiving the same care as their white counterparts. Something else is going on here,” he continued. “The truth is that health care disparities are exacerbated by the conscious and unconscious biases of health care professionals on the one hand, and the fear of bias by patients on the other.”
Slavin then urged medical providers to take action to identify where these biases exist and to combat them. “Quality and equality go hand-in-hand. There can’t be true quality without equality,” he said. He noted that MGH began its own “hard look” at practices and biases at the hospital a decade ago. “We started by assuming a mindset of ‘guilty until proven innocent.’ In other words, instead of just saying, ‘racial disparities don’t exist here,’ we said, ‘we’re going to assume they exist here. So let’s go find them and fix them.’ ”
In 2004, MGH founded the Disparities Solutions Center, which aims to collect data on disparities in health outcomes across different racial groups, identify and close quality gaps and work to create a more diverse and inclusive work environment at the hospital. Though many other medical centers have adopted similar programs, a tremendous amount of work remains to be done to eradicate the discrimination and inequalities that linger throughout the U.S. health care system.
“Our job is to heal,” said Slavin. “Our job is to save lives, regardless of what our patients look like, where they come from, what they believe, or who they love. Issues of equality and justice are not separate from the practice of medicine. They are central to the practice of medicine.”
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