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A new study published in the January issue of the Journal of Pain and Symptom Management points to racial bias in the treatment that patients receive toward the end of their lives, the Huffington Post reports.
Using actors to portray dying hospital patients, the study shows that the black “patients” received less-compassionate care from real doctors than the white “patients” received.
According to HuffPost, researchers studied 33 hospital-based doctors from western Pennsylvania, placing them in “high-fidelity” simulations in which the actor patients read from matching scripts while exhibiting the same simulated vital signs. Each “patient” was accompanied by another actor who was pretending to be a family member.
The doctors knew that they were part of a study, though they did not know what the study was about.
“Although we found that physicians said the same things to their black and white patients, communication is not just the spoken word,” Dr. Amber E. Barnato, an associate professor at the University of Pittsburgh School of Medicine and the study’s senior author, explained, according to HuffPost. “It also involves nonverbal cues, such as eye contact, body positioning and touch.”
And while doctors said similar things to patients of either race, black “patients” were left wanting when it came to those nonverbal cues.
When dealing with white patients, doctors were more likely to stand closer to the patient’s bedside and were more likely to touch the patient in a sympathetic manner. Meanwhile, with black patients, the doctors were more likely to remain standing by the door of the hospital room, holding a binder in their hand, which could be interpreted as a defensive or disengaged gesture.
Researchers who analyzed audio and video of the interactions gave each doctor a score for his or her nonverbal cues. The doctors, on average, scored 7 percent lower for interactions with the black actors.
“Poor nonverbal communication—something the physician may not even be aware he or she is doing—could explain why many black patients perceive discrimination in the health care setting,” Barnato added in a University of Pittsburgh Medical Center press release.
And this, Barnato added, could explain why blacks often opt for “extraordinary lifesaving measures,” out of a lack of trust of the doctor, who may suggest other options aimed at easing suffering.
“When you survey people in the community about their feelings on end-of-life care, blacks are only slightly more likely than whites to say they want aggressive, life-sustaining measures when terminally ill,” Barnato said. “However, blacks are much more likely than whites to request such care when they are faced with making the decision in the hospital.
“Body language is a significant tool in building trust—or mistrust—and physicians need to ensure that their body language isn’t contributing to that decision,” she continued. “To help black patients and their families feel welcome and encouraged to be partners in medical decision-making, it is critical that doctors be aware of their verbal and nonverbal communication and any unintentional biases.”
Read more at the Huffington Post and UMPC.
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