A Look at the Impact of Medical Biases on Patients
When booking an appointment with a new doctor, many people go ahead without fear and worry. However, for others, they jump through hoops to avoid having to see a new professional. The question can become, why are they so against taking care of their health? For those people, medical biases in healthcare can be frustrating, demeaning, and sometimes even deadly. In 2018, trust in medical professions was at 34% (Advisory Board). Today let's explore why there is such a great distrust towards our profession.
Between 1932 and 1972, Tuskegee Institute (now known as Tuskegee University), a historically Black college in Alabama, was the location of an unethical study conducted by the Center of Disease Control and Prevention (CDC) and the United States Public Health Service (PHS). In this study, 600 Black men were selected and told they would be receiving free health care from the federal government. Instead, almost 400 of these men who had latent syphilis were not informed of their diagnosis, while the other 200 men were used as the control group. The doctors in charge of this study told these men they had "bad blood" and would give their test subjects medicine that wasn't meant to cure syphilis. They wanted to see how the disease impacted those of different races. Even when penicillin became a widely known cure for syphilis, the doctors chose to ignore this and prevented them from getting the medicine they needed. This unethical experience led to many deaths and the birth of children who had congenital syphilis. Black men consistently mention this experiment when discussing why they don't seek medical attention, especially vaccines.
It is an ongoing joke that Latinos use vapor rub, lemons, and soup to cure their illnesses. When you've seen women in your community lied to by doctors and health care officials, it makes sense. Around the same time as the Tuskegee experiment, women in Puerto Rico were forcibly sterilized. The Puerto Rican government believed that the high population was the cause of poverty in the country. To combat this overpopulation, they begin to give information that sterilization was a reliable form of family planning. The U.S. government supported these claims by endorsing a program that sent officials from the health department to Puerto Rico's rural areas to advocate for these operations.
As time went on, these women began to integrate these operations into their lives after being told they would also be reversible. As textile work became more common for women, the factories were set up with family planning clinics offering free sterilizations. This didn't just impact Puerto Rican women; these procedures were done on Mexican women in California. In the late 1960s, this led to a class-action suit. In the end, the judge concluded that the situation was simply a misunderstanding despite the women-only speaking Spanish.
More recently, Black women have begun to speak out on the impact that medical biases have on their pregnancies and births. Black, American Indian, and Alaska Native women are two to three times more likely to die from pregnancy-related causes than white women (CDC). For Black women, this high mortality rate could be due to the high number of medical professionals who believe Black women have a higher pain tolerance.
Serena Williams, a famous tennis player, reported telling her nurses and doctor that she felt she had a blood clot. Despite being someone who knew her body, the nurses still dismissed her claims even though she had dealt with pulmonary embolism in the past. However, after she continued to push for someone to check, they found four blood clots in her lungs. Not all women are fortunate enough to know how to advocate for themselves. Knowing this happened to a woman who is celebrated for her athletic abilities, it is understandable that women who don't have the same privileges fear they will be ignored.
Finally, if you're fat, you often get told that your health issues are related to your weight. This weight bias does not prevent complications and instead aids them. Although there is evidence that higher weights can lead to chronic diseases and conditions, it is often assumed that once patients lose weight, they will see a decrease in their symptoms. However, according to an article in BMC Medicine,
"The nature of healthcare provider bias encompasses endorsement of negative stereotypes of patients with obesity, including terms like "lazy," "weak-willed," and "bad," feeling less respect for those patients, and being more likely to report them as a "waste of time." As the medical professional begins to use terms like "lazy" and "bad" they begin to see their patents as worthless leading them to ignore symptoms and possible causes.
These biases can cause lower quality of care, and those who have been deemed obese seek less medical care. When doctors and nurses look at a patient and use their BMI as a barometer, they shut people out of wanting to improve their health. When looking online, it is easy to find the experiences of people who were told they needed to lose weight for their symptoms to go away.
A woman recently took to Reddit to express her frustration and anger. She explained that after losing 75 pounds, her doctors finally took her numbing fingers, memory and balance problems, and headaches seriously. When finally diagnosed, she was told she would have to have her ovaries, a portion of her colon, and lower intestines removed. The anger she feels is understandable, and while she doesn't blame all doctors, this could have been prevented.
Now that we know why people distrust medical professionals, it's time to rebuild that trust. When anxieties are high, people choose to seek answers through the internet. While it's great that they feel empowered to find this information independently, this can lead to people not following up to get the help they desperately need. Let's talk about ways we can begin to combat these fears, make a connection, and check our own biases. Here are a few ways to build a relationship next time you're meeting with a patient.
Discuss Their Fears and Anxieties
You're not a psychologist; however, you are more likely to hear about their concerns first as a nurse. Please take a moment or two and indulge them. Ask open-ended questions about what is on their mind. Once you feel you have enough information, discuss it with the doctor. Being that additional advocate can make or break the visit. Doing this will also allow you the chance to combat misinformation they've heard from others.
Keep An Open Mind
As people worldwide share their symptoms and diagnoses, the patient could be applying the information to themselves. While misinformation can happen, the patient knows their body best. They may forget to mention symptoms but when they come in with possible diagnoses, take them seriously. Seeking out information and confirmation can often happen with people who have lupus. Due to the wide range of symptoms and a lack of tests, they have had to seek out medical answers on their own then return to their doctors with what they've they've found.
Share Your Own Experiences
Sharing how you or someone you know dealt with something similar can help decrease the feeling of loneliness. By sharing these experiences, you can help create a space where the patient feels more comfortable sharing more. Everyone enjoys a feel-good story, and this time is no different. Giving the patient a chance to ask questions they might not have thought of previously will help you learn more about their feelings and medical concerns.
A great thing about being a nurse is that you come into contact with many different people. These encounters can inform future interactions so when a patient is sharing their concerns, listen to what they're saying and ask questions about what they aren't saying. Mind your personal biases because they might seem dramatic on the outside, but many people feel their medical needs get dismissed and ignored. By combining your previous experiences and compassion, you can create safer spaces for marginalized groups.
These experiences can leave doubt in anyone's head on why they shouldn't seek help. They are right to be disappointed, confused, and angry. However, with the knowledge of knowing why people are quick to deal with their issues on their own, we can begin to close the gap that has been created. By taking these small steps and leading with compassion, we can rebuild trust in the medical community.
Sources to note:
www.advisory.com/en/daily-briefing/2018/02/16/trusting-medical-professionals.