Sunday, October 18, 2009

Race Playing a Factor In Health Care In Hospitals

. John Reid, shown with his regular doctor Neil Calman, says race played a role during an ER visit.

By Adam Lindheim

John Reid who is a retired businessman had just returned from a cruise to the Caribbean with an infected toe. As a diabetic he knew it was something he needed to have checked out immediately. The first doctor he saw in the emergency room told him he had to have the toe amputated right then, and scheduled him for surgery instantly. Reid was not content with the doctors recommendation and demanded he see a more senior doctor for a second opinion. The head doctor recommended a treatment plan of intravenous antibiotics and physical therapy. This treatment plan was more expensive and time consuming than the amputation, but Reid firmly believes because he is an African American the junior doctor was quicker to recommend a cheaper and more drastic treatment. Dr. Norm Oliver, director or the University of Virginia Center on Health Disparities as well as numerous studies have proven that white physicians carry unconscious biases against Latinos and African Americans. This is issue have proven even more controversial with child care.

Cincinnati Children’s Hospital Medical Center, researchers analyzed data on 818 chest-pain related emergency department visits made by children and teens included in the National Hospital Ambulatory Medical Care survey between 2002 and 2006. They found that 71 percent of white children were given either an EKG, chest x-ray, or a complete blood count, compared with 59 percent of black children. This translated into white children being 1.6 times more likely than black children to recieve testing for chest pain. This not the first time studies about this kid of behavior has been done.

In a landmark study by Schulman et al, African American patietns are less likely than white patietns to recieve life-saving therapy for a heart attack, even if the presentation of the African American patient is the same as a caucasion patient expect for the skin color. Schulman et al study has been replicated numerous times of the past 10 years, and most recently by Green et al. Green et al supported Schulman's findings, and did by using the Implicit Association Test (IAT) to measure the unconscious biases of dcotors. This test is a well validated instrument which has beeb used in more than 400 studies and on more than 10 million subjects.

These studies open a very important question when it comes to new healthcare reform. As the government continues to attempt to create a comprehnsive plan that covers every U.S. citizen, the question remains will patient care for all races be the same. If citizens are going to pay some sort of fee to the government for healthcare, the government needs to make sure they regulate the type of care given to patients and insure that it is equal no more what race the patient is.

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