Addressing Racial Biases in Medicine: A Review of the Literature, Critique, and Recommendations

Abstract

<jats:p> This article reviews the literature on racism in medicine in the United States and reflects on the persistent barriers to diminishing racial biases in the U.S. health care system. Espoused strategies for decreasing racial disparities and reducing racial biases among physicians are critiqued, and recommendations are offered. Those recommendations include increasing the number of minority students in medical school, using Xavier University in New Orleans, Louisiana, as the model for medical school preparation; revamping the teaching of cultural competence; ensuring the quality of non-clinical staff; and reducing the risk of burnout among medical providers. </jats:p>

Sources of Information and Health Care Experiences Related to COVID-19 among Women Involved in Criminal Legal System in Three U.S. Cities

“…In addition, very few Black women identified health care providers as their most trusted source. The long history of racism in government and criminal justice policies in the United States likely contributes to this mistrust [20,21], as does the legacy of unequal treatment and abuse in U.S. medicine [20,22] Restorative work with communities of color is needed to address medical mistrust [23,24], particularly if a future vaccine is to be widely accepted among vulnerable groups [25]. Finally, it is striking that a notable proportion of women (15%) said they didn't trust ANY source of information regarding COVID-19.…”

HIV Beliefs Among African Americans with HIV/AIDS in the Deep South Can Time Heal Old Wounds?

“…The framing of the message as a conspiracy, rather than HIV beliefs, may be a disservice to prevention and treatment efforts as well as to discount the lived experiences of Black Americans, the historic racism and cause for distrust. It takes little imagination, as other authors acknowledge, to then blame minorities for their paranoia and to feed into the lingering stereotypes of Blacks [94] as "gullible conspiracy mongers [95], and believing "mere nonsense" [96]. Medical rumor beliefs are stigmatized knowledge [97,98] that complicate treatment and prevention efforts.…”

Thinking with two brains: Student perspectives on the presentation of race in pre‐clinical medical education

“…Reviews of the topic, published in 2015, 2017, and 2020, found that while racial/ethnic implicit bias is present, specifically positive attitude towards Whites, it is more likely to be related to patient-provider interactions with no impact on clinical decision-making. [9][10][11] There are various contexts in which the race of patients can be presented, documented or used in medical education, including writing a History of Present of Illness (HPI), answering board-style questions, participating in problem-based learning (PBL) modules, and as a mental shortcut for memorising diseases. In clinical case presentations, the inclusion or exclusion of race in opening statements varies widely across US medical schools, states Nawaz & Brett.…”

“…Similarly, Druckman et al 8 found that medical staff perceived Black athletes to feel less pain than White athletes; this race effect was mediated by perceptions of social class. Reviews of the topic, published in 2015, 2017, and 2020, found that while racial/ethnic implicit bias is present, specifically positive attitude towards Whites, it is more likely to be related to patient‐provider interactions with no impact on clinical decision‐making 9‐11 …”