From neonatal and primary care to emergency medicine, kids got lower-quality care than their white peers, researchers found. Disparities include longer waits and less pain medication after surgery.
From neonatal and primary care to emergency medicine, kids got lower-quality care than their white peers, researchers found. Disparities include longer waits and less pain medication after surgery.
It’s also implicit bias, though. Health care providers have to make assessments of their patients constantly: does this person need more pain meds? Can we discharge them? Do they need surgery or just physical therapy? And implicit bias (for example the very well-known bias that Black women can ‘handle’ more physical pain than white women because they’re ‘tougher’) will be one factor in these thousands of constant little decisions. If you looked at any one decision you probably couldn’t find fault with it, but they add up over time and if you look at the data you’ll find statistical trends. Black women are more commonly recommended to have C-sections than white women, all other factors being equal. That’s not because individual doctors hate Black women, but it’s because unconscious biases affect their decision making, and because race is considered as a risk factor for certain treatment decisions.
I’m having a hard time imagining that someone would withhold pain management assuming the patient can just handle more pain or because they’re tough. To me, that would be insane. I’m not saying it’s not happening, I just can’t understand.
Let’s say it’s normal to keep someone on pain meds for 4 to 8 days after surgery. Each day, you assess the patient and check a number of factors to determine when to stop pain meds, like: how much pain do they say they’re in? How much do they wince when they walk? How comfortable do they seem? Do they seem distracted when talking to you? Etc. Each of those assessments is subjective, and therefore can be influenced by biases you don’t even realize you have. Over a year, maybe that means you stop pain meds on the 5th day, on average, for Black patients, and on the 6th day for white patients. You’re not really withholding pain meds from any one patient. Each patient probably doesn’t really notice the difference. But over time, that slight difference compounds and adds up to poorer quality of care for one group.
This is why it’s so important to measure things like this subjectively, and look for and fix the reasons they’re happening. It’s very hard, probably impossible, to fix these issues by just assuming that well-meaning people will be able to be completely unaffected by bias. And sometimes people overcorrect: managers in tech are less likely to give Black employees critical feedback, for example, because they don’t want to be racist, and that behavior harms Black employees by not giving them opportunities to correct behavior that’s holding them back from advancement. Again, tiny behaviors that compound at scale.