Racial bias from white physicians

[Playball40]

Probably not relevant, but I'm finding just about ALL doctors these days are dismissing "pain" because they are afraid to prescribe ANY narcotics.

I think it depends on where you live. It's not that hard to get narcotic pain relievers in the area of Georgia where I live, at least if you're white, not sure if you're black. But, when I was living in Indy briefly, they acted as if Rx. pain meds were heroin. According to my sister, it's the same way in NJ. We do have a regulation in Ga. that you must be seen by a provider at least every three months and have a drug test done every three months. My providers require at least a virtual visit monthly, which I find a waste of time for me and them.

The truth is that narcotic pain relievers are much safer compared to NSAIDS for most older adults. One of my former patients nearly died from a Rx. NSAID, but was later put on a narcotic after her recovery from the severe GI bleed.

Both Florida and Virginia are impossible.

 

[Colonel Sanders]

Definitely

Forgot one that's not typically thought about, age bias. Medical's can be both offender and victim. I typically avoid old surgeons, and any medical that is overtly religious.

I've found that some physicians are similar to politicians. No matter how old they are, they hate giving up their power. There was one in my town who was an orthopedic surgeon. He was around 80 and he finally retired after giving the wrong injection to a patient. I'm not that far from 80, but no way would I remain doing things like surgery or trying to run the country at my age. Yet was have both doctors and politicians in their 80s and some in their 90s, who won't give up their power.

There was one doctor in my town who insisted on praying prior to providing care. I helped my one openly atheist patient find another doctor. She was a kind, sweet, Hindu who never pushed her religious beliefs on anyone.

It's a tough call.

Some people simply can't bring themselves to retire. Some are still competent, some are not. But when you do see incompetence at any age it's alarming and there's usually nothing you can do about it. I used to have to appear before an ancient judge who still made decisions using doctrine that was done away with in the early 70s. Everyone says, "You need to appeal that!" but the problem is that very few people have the money to appeal a judgment no matter how egregious it is.

OTOH, I appeared before another old guy who was one of my favorites. He'd seen it all ten times over (probably more) and made good decisions and what was even better was that he'd fully explain why he came to the decision he did, which helped litigants feel better even if things didn't go their way. It also took a lot of pressure off us because clients already understood what had just happened without needing a lot of explanation from me.

 

[southernhybrid]

Probably not relevant, but I'm finding just about ALL doctors these days are dismissing "pain" because they are afraid to prescribe ANY narcotics.

I think it depends on where you live. It's not that hard to get narcotic pain relievers in the area of Georgia where I live, at least if you're white, not sure if you're black. But, when I was living in Indy briefly, they acted as if Rx. pain meds were heroin. According to my sister, it's the same way in NJ. We do have a regulation in Ga. that you must be seen by a provider at least every three months and have a drug test done every three months. My providers require at least a virtual visit monthly, which I find a waste of time for me and them.

The truth is that narcotic pain relievers are much safer compared to NSAIDS for most older adults. One of my former patients nearly died from a Rx. NSAID, but was later put on a narcotic after her recovery from the severe GI bleed.

Both Florida and Virginia are impossible.

I do have a friend who lives in Florida who has been suffering with severe knee pain for years and she finally got some Rx. Tramadol, which isn't really a narcotic but is a control drug. I took it for a couple of years and it barely helped my pain and then it gave me seizures. The neurologist I saw afterwards told me that tramadol acts in a very strange way on the brain and a tiny percentage of people do get seizures from taking it. After more than 15 years without another seizure, I'm finally getting weaned off of my seizure med. I read that if you haven't had a seizure in a few years, it's safe to stop the med. Of course, it should be stopped gradually.

After stopping the tramadol, I took NSAIDs ( just Advil ) for awhile, as I could tolerate it back then. A wonderful NP finally gave me RX. narcotics, which I've been taking for over 8 years without a single side effect and they still bring down my pain level to a tolerable level.

Idiot doctors over prescribed narcotics for many years. I even read that some were exchanging sex for the prescriptions. I had one patient who was on a very high dose of fentanyl as well as hydrocodone. In fact, the doctor had the staff changing her patch every 2 days, when it should have been every 3 days. She ended up with pneumonia, as narcotics sometimes decrease one's respirations. After she recovered, the PA put her on codeine twice a day. The last time I saw her, she was taking tramadol extended relief. I'm talking about a woman who weighed about 95 lbs. Thanks to the awful doctors, it's now much more difficult to get pain relief.

Where I go, one does have to show evidence of pain. My tests show osteoporosis, degenerative disc disease and severe osteoarthritis in my feet, knees and hands. I have also had bursitis in my hips. The primary source of pain is in my feet and knees, despite having had partial knee replacements in the last few years. I've even tried a program that is supposed to help you reprogram your nociceptors so you don't feel pain. It didn't help me at all, but I've read three books on the subject and apparently it does help some people It seems to mostly help those who have had an injury and the pain continues long after the injury is healed.

 

[brewer]

I think it depends on where you live. It's not that hard to get narcotic pain relievers in the area of Georgia where I live, at least if you're white, not sure if you're black. But, when I was living in Indy briefly, they acted as if Rx. pain meds were heroin. According to my sister, it's the same way in NJ. We do have a regulation in Ga. that you must be seen by a provider at least every three months and have a drug test done every three months. My providers require at least a virtual visit monthly, which I find a waste of time for me and them.

The truth is that narcotic pain relievers are much safer compared to NSAIDS for most older adults. One of my former patients nearly died from a Rx. NSAID, but was later put on a narcotic after her recovery from the severe GI bleed.

bold: Depends on the patient overall health/function, condition being treated and administration. My guess is that the patient was elderly and on oral administration for a chronic condition.

 

[southernhybrid]

The military is notorious for downplaying pain across all branches and for all servicemembers.

It is much easier (in the world outside of the military) for white people to have their pain recognized and treated compared with persons of color. Enslaved black people, Native Americans and Chinese workers were widely thought to feel little pain because of their stoicism, which was necessary if they were to survive living under whites. When one wishes to treat another human being as little more than livestock, one must by necessity develop some myths about them to justify such treatment--actually worse treatment than livestock. So, white people decided that certain groups of people did not actually feel pain, were too stupid to learn to read or do math or even to learn good English or to be anything other than manual labor and servants.

The military cultivates a similar attitude towards its servicemembers for similar reasons: there are jobs in the military which must be carried out irrespective of pain. I think it's pretty fucked up (except when absolutely necessary such as in combat) but it's definitely a thing.

My personal beliefs are that pain is a symptom of something wrong and the sooner it is addressed, the better--both the pain and the underlying cause.

I'm not sure how veterans are treated these days when it comes to pain, but my later father who was disabled from severe PTSD had no trouble getting pain meds. He took methadone, hydrocodone and Advil, which is could still tolerate. He also took something for anxiety, but he still complained of pain. Of course, he was white.

It is usually easier for older adults to get narcotics because it's the younger adults who have abused them more than older people. At least that is what the NP who started me on the narcotics told me when she prescribed some for me.

I have another dear black male friend who is a veteran with PTSD, but he doesn't like taking Rx. drugs. He claims that green sea moss helps him. One has to be very careful where the source comes from because sometimes that stuff has some bad chemicals in it. Sorry I don't recall exactly what, but my friend was aware of that and he claims his source is very safe. Some people are even helped with placebos. I read a study about that many years ago. Whatever works.

 

[Toni]

As a matter of fact, I have a very close Black friend who has suffered with chronic pain for years, yet the same doctor who originally approved narcotic pain relievers for me, has kept her on gabapentin for years until she recently asked him to wean her off of it, as it never decreased her pain. I've read that this is not unusual and while I hate to think that this doctor might have some racial bias, it does seem to be somewhat common among white physicians to treat their black patients differently, especially when it comes to pain. Plus, sometimes people aren't even aware of their racial bias.

I've also read that black folks, especially black males often don't trust white doctors. I can understand why so that is another reason why more black students who have decent MCATS and grades need to be approved for medical school. One doesn't have to have the highest MCAT score to become a good doctor, as that as already been documented in the other thread. One needs to be willing to learn, to have compassion, to be open minded, caring and keep up with the latest medical science to be a good doctor and perhaps one of the most important things is to treat all of your patients equally, regardless of their race, age, gender etc. The first thing Iearned when studying nursing was never to judge my patients, and to provide good care to all of them. That has always stayed with me, and I try to apply it to others as much as I am able, now that I'm retired.

One more thing. Just because the over all population is still mostly white, I live in a small city where the black population is about 51% and the white population is 49%, so shouldn't we have more black doctors and NPs than the over all population in the US? Some black doctors aren't very good and some white doctors are also incompetent, but it has nothing to do with their race. We also have a sprinkling lot Asian and Hispanic folks in my city but like my neighborhood, it's mostly a mix of black nd white. And, the last time I checked ATL was still majority black, but I doubt the medical community in ATL is mostly black.

If there really is bias between white and black doctors, I believe the fix you propose is even worse IMO. Reducing metrics just so that more black doctors are admitted would be hugely flawed and would make the profession even worse not just for blacks but for everyone. You make the claim MCAT scores don't mean anything. Ok fine. Then measure how good the doctor can perform in some other meaningful way. But the key is measuring everyone exactly the same way and letting the chips fall where they do. Even if that means more Asians than Blacks.

Otherwise you run the very real risk of patients (especially white ones) who will not go to black doctors because they rightly fear they did not pass what the others could perform. And that would be much worse than any supposed bias in the first place.

Again, as useless as it is to point facts out to bigots: Metrics are not lowered to accommodate black applicants

ALL applicants accepted by medical school meet the threshold MCAT score and requisite GPA and have supporting letters of recommendation and other documentation along with their applications plus interviews, etc.

We only know that the average MCAT score of black applicants offered spots in any medical school is slightly less than the average scores of Asian and white applicants. That does not tell us if the highest scoring applicant was black, white, Hispanic, Asian, NA, etc. or if the lowest scores of accepted students were from Asian or white students.

We have only average scores by demographic if race was reported. Not all applicants report their race.

Beyond test and MCAT scores, we know that medical scores also look at what the intentions of their applicant pool is. A school that specializes in medical research will choose different you than a school with special emphasis on oncology, or general practice, etc.

 

[Toni]

The military is notorious for downplaying pain across all branches and for all servicemembers.

It is much easier (in the world outside of the military) for white people to have their pain recognized and treated compared with persons of color. Enslaved black people, Native Americans and Chinese workers were widely thought to feel little pain because of their stoicism, which was necessary if they were to survive living under whites. When one wishes to treat another human being as little more than livestock, one must by necessity develop some myths about them to justify such treatment--actually worse treatment than livestock. So, white people decided that certain groups of people did not actually feel pain, were too stupid to learn to read or do math or even to learn good English or to be anything other than manual labor and servants.

The military cultivates a similar attitude towards its servicemembers for similar reasons: there are jobs in the military which must be carried out irrespective of pain. I think it's pretty fucked up (except when absolutely necessary such as in combat) but it's definitely a thing.

My personal beliefs are that pain is a symptom of something wrong and the sooner it is addressed, the better--both the pain and the underlying cause.

I'm not sure how veterans are treated these days when it comes to pain, but my later father who was disabled from severe PTSD had no trouble getting pain meds. He took methadone, hydrocodone and Advil, which is could still tolerate. He also took something for anxiety, but he still complained of pain. Of course, he was white.

It is usually easier for older adults to get narcotics because it's the younger adults who have abused them more than older people. At least that is what the NP who started me on the narcotics told me when she prescribed some for me.

I have another dear black male friend who is a veteran with PTSD, but he doesn't like taking Rx. drugs. He claims that green sea moss helps him. One has to be very careful where the source comes from because sometimes that stuff has some bad chemicals in it. Sorry I don't recall exactly what, but my friend was aware of that and he claims his source is very safe. Some people are even helped with placebos. I read a study about that many years ago. Whatever works.

I believe that the level of pain tolerance expected is very different fir active service members, especially if deployed/at sea compared with those who are retired, especially retired on disability.

 

[ideologyhunter]

Racist blast from the past: my late mother worked for the Cleveland Clinic around 1949-50, taking phone calls to various departments. She was told by her supervisors that, if she was reasonably sure the caller was black (actually Negro, since this was almost 80 years ago), she was to try to put them off. Specifically, she had a list of Negro MDs and their area of expertise in the Cleveland area, and she was told to make recommendations from that list.
My parents were anything but racially enlightened, but she knew that something reeked in that scheme, and she told the story for the rest of her life.

 

[RVonse]

As a matter of fact, I have a very close Black friend who has suffered with chronic pain for years, yet the same doctor who originally approved narcotic pain relievers for me, has kept her on gabapentin for years until she recently asked him to wean her off of it, as it never decreased her pain. I've read that this is not unusual and while I hate to think that this doctor might have some racial bias, it does seem to be somewhat common among white physicians to treat their black patients differently, especially when it comes to pain. Plus, sometimes people aren't even aware of their racial bias.

I've also read that black folks, especially black males often don't trust white doctors. I can understand why so that is another reason why more black students who have decent MCATS and grades need to be approved for medical school. One doesn't have to have the highest MCAT score to become a good doctor, The first thing Iearned when studying nursing was never to judge my patients, and to provide good care to all of them. That has always stayed with me, and I try to apply it to others as much as I am able, now that I'm retired.

One more thing. Just because the over all population is still mostly white, I live in a small city where the black population is about 51% and the white population is 49%, so shouldn't we have more black doctors and NPs than the over all population in the US? Some black doctors aren't very good and some white doctors are also incompetent, but it has nothing to do with their race. We also have a sprinkling lot Asian and Hispanic folks in my city but like my neighborhood, it's mostly a mix of black nd white. And, the last time I checked ATL was still majority black, but I doubt the medical community in ATL is mostly black.

If there really is bias between white and black doctors, I believe the fix you propose is even worse IMO. Reducing metrics just so that more black doctors are admitted would be hugely flawed and would make the profession even worse not just for blacks but for everyone. You make the claim MCAT scores don't mean anything. Ok fine. Then measure how good the doctor can perform in some other meaningful way. But the key is measuring everyone exactly the same way and letting the chips fall where they do. Even if that means more Asians than Blacks.

Otherwise you run the very real risk of patients (especially white ones) who will not go to black doctors because they rightly fear they did not pass what the others could perform. And that would be much worse than any supposed bias in the first place.

Again, as useless as it is to point facts out to bigots: Metrics are not lowered to accommodate black applicants

Who said anything about metrics currently being lowered to accommodate blacks applicants today? And who said anything about bigots except for yourself?

Southernhybrid's OP is her opinon that I responded to. And I still stand behind my rebuttal because her solution for lowering metrics to include blacks would only make things worse off for the whole population, blacks included. The overall standard of medical care would suffer by reducing metrics by including sub standard doctors regardless of their skin color. Worse than that is the message to the public that blacks were "only let in to meet a quota". The solution being worse than the original problem.

 

[Toni]

As a matter of fact, I have a very close Black friend who has suffered with chronic pain for years, yet the same doctor who originally approved narcotic pain relievers for me, has kept her on gabapentin for years until she recently asked him to wean her off of it, as it never decreased her pain. I've read that this is not unusual and while I hate to think that this doctor might have some racial bias, it does seem to be somewhat common among white physicians to treat their black patients differently, especially when it comes to pain. Plus, sometimes people aren't even aware of their racial bias.

I've also read that black folks, especially black males often don't trust white doctors. I can understand why so that is another reason why more black students who have decent MCATS and grades need to be approved for medical school. One doesn't have to have the highest MCAT score to become a good doctor, The first thing Iearned when studying nursing was never to judge my patients, and to provide good care to all of them. That has always stayed with me, and I try to apply it to others as much as I am able, now that I'm retired.

One more thing. Just because the over all population is still mostly white, I live in a small city where the black population is about 51% and the white population is 49%, so shouldn't we have more black doctors and NPs than the over all population in the US? Some black doctors aren't very good and some white doctors are also incompetent, but it has nothing to do with their race. We also have a sprinkling lot Asian and Hispanic folks in my city but like my neighborhood, it's mostly a mix of black nd white. And, the last time I checked ATL was still majority black, but I doubt the medical community in ATL is mostly black.

If there really is bias between white and black doctors, I believe the fix you propose is even worse IMO. Reducing metrics just so that more black doctors are admitted would be hugely flawed and would make the profession even worse not just for blacks but for everyone. You make the claim MCAT scores don't mean anything. Ok fine. Then measure how good the doctor can perform in some other meaningful way. But the key is measuring everyone exactly the same way and letting the chips fall where they do. Even if that means more Asians than Blacks.

Otherwise you run the very real risk of patients (especially white ones) who will not go to black doctors because they rightly fear they did not pass what the others could perform. And that would be much worse than any supposed bias in the first place.

Again, as useless as it is to point facts out to bigots: Metrics are not lowered to accommodate black applicants

Who said anything about metrics currently being lowered to accommodate blacks applicants today? And who said anything about bigots except for yourself?

Southernhybrid's OP is her opinon that I responded to. And I still stand behind my rebuttal because her solution for lowering metrics to include blacks would only make things worse off for the whole population, blacks included. The overall standard of medical care would suffer by reducing metrics by including sub standard doctors regardless of their skin color. Worse than that is the message to the public that blacks were "only let in to meet a quota". The solution being worse than the original problem.

Yeah, nobody’s talking about needing to lower standards to include black people. Nobody at all..

 

[southernhybrid]

As a matter of fact, I have a very close Black friend who has suffered with chronic pain for years, yet the same doctor who originally approved narcotic pain relievers for me, has kept her on gabapentin for years until she recently asked him to wean her off of it, as it never decreased her pain. I've read that this is not unusual and while I hate to think that this doctor might have some racial bias, it does seem to be somewhat common among white physicians to treat their black patients differently, especially when it comes to pain. Plus, sometimes people aren't even aware of their racial bias.

I've also read that black folks, especially black males often don't trust white doctors. I can understand why so that is another reason why more black students who have decent MCATS and grades need to be approved for medical school. One doesn't have to have the highest MCAT score to become a good doctor, The first thing Iearned when studying nursing was never to judge my patients, and to provide good care to all of them. That has always stayed with me, and I try to apply it to others as much as I am able, now that I'm retired.

One more thing. Just because the over all population is still mostly white, I live in a small city where the black population is about 51% and the white population is 49%, so shouldn't we have more black doctors and NPs than the over all population in the US? Some black doctors aren't very good and some white doctors are also incompetent, but it has nothing to do with their race. We also have a sprinkling lot Asian and Hispanic folks in my city but like my neighborhood, it's mostly a mix of black nd white. And, the last time I checked ATL was still majority black, but I doubt the medical community in ATL is mostly black.

If there really is bias between white and black doctors, I believe the fix you propose is even worse IMO. Reducing metrics just so that more black doctors are admitted would be hugely flawed and would make the profession even worse not just for blacks but for everyone. You make the claim MCAT scores don't mean anything. Ok fine. Then measure how good the doctor can perform in some other meaningful way. But the key is measuring everyone exactly the same way and letting the chips fall where they do. Even if that means more Asians than Blacks.

Otherwise you run the very real risk of patients (especially white ones) who will not go to black doctors because they rightly fear they did not pass what the others could perform. And that would be much worse than any supposed bias in the first place.

Again, as useless as it is to point facts out to bigots: Metrics are not lowered to accommodate black applicants

Who said anything about metrics currently being lowered to accommodate blacks applicants today? And who said anything about bigots except for yourself?

Southernhybrid's OP is her opinon that I responded to. And I still stand behind my rebuttal because her solution for lowering metrics to include blacks would only make things worse off for the whole population, blacks included. The overall standard of medical care would suffer by reducing metrics by including sub standard doctors regardless of their skin color. Worse than that is the message to the public that blacks were "only let in to meet a quota". The solution being worse than the original problem.

Yeah, nobody’s talking about needing to lower standards to include black people. Nobody at all..

Two of the smartest girls in my high school class were black and one of their father's was a physician. My town in NJ was highly racially segregated so these two girls who I only knew because they were both in my English class lived in a small somewhat affluent part of town which was all populated by black professionals. They were the first black girls I ever got to know. That was in the 60s when segregation was everywhere. So, making the assumption that having more black people become black physicians would lower the standards of medical doctors is pure racism.

When I was young there were hardly any black nurses and the one who I worked with in public health thanked me for being on her team. At first I had no idea what she was talking about but then I realized I was the only one who fully accepted her as a colleague and never thought of her as anything less. Racial bias is not always recognized, but while it may not be as bad as it once was, it still exists and in some ways is getting worse again. I don't think I need to explain that to anyone who is paying attention.

I feel privileged to live in a very racially integrated area, to have so many black friends and neighbors, to enjoy and appreciate black culture, the warmth and friendlessness expressed by most. I never had that opportunity growing up in the Northeast where to this day most areas remain segregated. Cultural diversity is one of the things that brings joy to life and not judging others based on their race or ethnicity is sanity imo.

There are incompetent doctors of all races and one is lucky in my opinion if you can find a good, caring competent doctor of any race. Having emotional intelligence is just as important to be a good physician as it is to have intellectual intelligence.