The Discrimination Black Americans Face When It Comes to Pain Management
- Experts say doctors diagnose and treat Black Americans differently for pain management.
- They say this is partly because of the mistaken belief of some medical professionals that Black people feel pain differently than white people.
- Experts are encouraging the medical profession to make changes to avoid this and other systemic discriminatory practices.
“He made me feel like I was a drug addict and he knew I was a physician and I don’t take narcotics.”
Dr. Susan Moore said that and much more in a video she recorded from her hospital bed last December, then posted to Facebook.
The 53-year-old Black physician was being treated for COVID-19 at Indiana University Health North Hospital (IU Health).
In her video, Moore said that the white doctor treating her was dismissive of her request to continue the remdesivir antiviral treatment she had started.
She said he wouldn’t give her anything for pain until she pushed to get a CT scan that showed her condition was worsening.
Moore called her treatment racist.
“You have to show proof that you have something wrong with you in order for you to get the medicine. I put forth and I maintain that if I was white, I wouldn’t have to go through that,” she said.
Two weeks later, Moore died from COVID-19 complications.
Her video went viral and has reignited a call to end discrimination for Black people seeking healthcare.
“She was not just any patient saying they’re being racist, she was a doctor and she knew how she should be treated. That’s why her voice was so powerful,” said Dr. Camara Phyllis Jones, MPH, an adjunct professor at the Morehouse School of Medicine in Atlanta.
In a statement to Healthline, IU Health officials said an external review is being conducted by “six leading national and local healthcare and diversity experts with a demonstrated track record of patient advocacy and expertise on systemic racism, cultural competency, diversity and inclusion.”
Racial bias in medical care
Jones said there’s a history of doctors assuming Black patients are drug seeking.
“That includes those who have sickle cell and go to the hospital in pain and in a crisis,” she told Healthline.
Multiple studies have shown that racial disparities in healthcare are particularly evident when it comes to treating pain.
A 2016 study reported that Black Americans are less likely to be treated for pain, and when they do get treatment, they’re given a lower dose of pain medicine.
Why?
In part, the study stated, because beginning in medical school, some students hold false beliefs that Black people are biologically different from white people.
These students don’t believe Black people feel pain in the same way, that Black people have “thicker skin” than white people.
A Duke University study in 2000 reported that medical students asked to evaluate chest pain showed racial biases even before they began their clinical work.
Experts say those beliefs are rooted in slavery.
“In the 1830s and ’40s, the field of medicine was basically experimenting in order to justify slavery as an institution. The goal was to show that Black bodies were inferior to white bodies, that they were less sensitive to pain, which justified inflicting pain,” said Janice A. Sabin, PhD, MSW, a research associate professor at the University of Washington who studies the role of implicit bias in racial disparities in healthcare.
But one medical school professor told Healthline she sees some progress on that front.
“In my own experience I see attitudes being different,” said Keisha Ray, PhD, an assistant professor at the McGovern Medical School at the University of Texas Health Science Center at Houston.
“The students find statements that Black people don’t feel pain like white people silly. Their clinical experience and time in the classroom tell them otherwise. So, anecdotally I see changes,” Ray said.
“Research like this, although disheartening, gives us the tools to better educate medical students so they can become great physicians for Black people and help reduce some of the barriers Black people face in healthcare,” she added.
Systemic bias in healthcare
Experts say it’s not a surprise that there’s racial bias in the medical field, as healthcare mirrors the larger society.
“The root is white supremacy ideology, a false belief in a hierarchy that puts white people at the top, and it results in a dehumanization of people of color,” Jones said. “And there are cultural and societal barriers to achieving health equity.”
Ray said Black people face more obstacles than white people in getting medical care, and once in the clinical setting, Black people often experience bias in the diagnostic testing and treatments healthcare professionals use.
“Institutional racism in healthcare stops Black people from receiving good care that leads to good health outcomes,” she said.
Working on a fix
The American Medical Association has set out a series of goals and policiesTrusted Source to recognize racism as an urgent public health threat and to mitigate its effects.
“There are ways to test your own bias. We often use the implicit association test in research and as an educational tool,” Sabin told Healthline. “You can take that information and say, ‘This is an area that I need to be careful about as I care for patients or interact with others.’”
“What we need to do is train more Black doctors. But to do that we need amazing preschools, we need to help families so that children don’t grow up in poverty. We need massive investments in communities of color,” Jones said.
The White Coats Black Doctors Foundation is working to increase diversity in the medical profession by encouraging and supporting the development of future Black physicians.
For now, Jones said you might want to take along an ally to your doctors’ appointments.
“A family member might be able to advocate for you and ask questions on your behalf,” she said. “But, unfortunately, now because of COVID-19 that’s often not possible.”
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