People of different races wear medical masks on a white background. Quarantine concept.Novel coronavirus 2019-nCoV, vector illustration
The Covid-19 pandemic has revealed the reality of medical racism. Research at Johns Hopkins found that Covid-19 and its long-term effects are enlarged Through structural racism and discrimination.First, Black, Hispanic and Native American workers are most likely to be employed in industries such as restaurants, tourism, retail and manufacturing Disproportionately affected by the epidemic. because Existing health inequalities In the healthcare system, a minority of patients are also more reluctant to seek medical care.Additionally, when Black, Hispanic, and Native American populations contract Covid-19, they are higher morbidity and mortality.
Even if a patient has experienced a mild case of Covid-19, it is still possible for them to have symptoms that persist long after their initial diagnosis.This group of people are known as Covid long-haulers, and their condition is often referred to as long term covidIn the early days of the pandemic, little was known about Long Covid, and many doctors did not believe it existed and did not have the proper resources to formally diagnose it.Complicating matters, experts believe a small number of patients may greatest risk For long-term covid.Without a Long Covid diagnosis, it is difficult for patients to get proper care, participate in Long Covid research, take sick leave From work to rest – the main recommended treatment – or access to disability benefits.
It wasn’t until June 14, 2021 that the CDC finally released the guide used to diagnose this condition. In the absence of specific guidance on how to diagnose and treat the disease, the symptoms of many minority patients are ignored, further marginalizing patients who already face barriers to receiving health care.
The role of racism in healthcare treatment
Racism in medicine is not a new topic. In fact, research has found that both medical diagnoses and doctors’ perceptions are riddled with racism. Medical diagnoses may appear ‘objective’, but they may include deep-rooted racism. For example, race factors in measures of kidney function, so black patients are less likely to receive a kidney transplant than white patients.Thus, although African Americans constitute more than one third of dialysis recipients, they only receive one fifth Every kidney transplant.
What’s more, physician bias can unknowingly harm marginalized patients.about false beliefs pain tolerance Meaning some doctors will prescribe painkillers for black patients. In fact, Dr. Susan Moore, a black doctor hospitalized with Covid-19 in December 2020, posted on Facebook A video recorded on her smartphone went viralIn the video, she details her doctor’s reluctance to prescribe medication for her coronavirus-related pain. After being asked to be transferred to another hospital, she was eventually discharged – and soon re-entered into another intensive care unit, where she died.
Understanding the patient’s background and culture – so-called cultural competence – Play an important role in healthcare.For example, when black patients see a black doctor, they are more likely to follow the doctor’s advice life-saving preventive care. One can also see the importance of cultural competence in healthcare historically: in the 17th century, communities midwife Serves pregnant Black, Indigenous, and immigrant women. Midwives are informal apprentices who understand the culture and traditions of their patients. In the 1920s, new midwifery licences eliminated apprentice midwives.Pregnant black women today often choose to escape at least one aspect of racism in obstetric care by choosing black doctor.
Hospitals that mimic high-reliability organizations
One of the ways to reduce discrimination in medicine is for hospitals, clinics and other medical groups to cultivate High Reliability Organization or HROloosely defined as “an organization that functions in a complex manner, High-risk areas No serious accident or catastrophic failure for a long time. “
A classic example of HRO can be found in the aviation industry. For example, airplane pilots are tasked with making long lists to make sure everything goes smoothly in flight, as failure to follow the rules can lead to disaster. A doctor’s office that acts as an HRO works similarly. In a pandemic, that means keeping clean, washing hands and wearing masks. The medical office that acts as an HRO knows exactly what to tell patients to help them get the best standard of care. Medical HROs do not ignore patients, instead, they speak directly to patients and place them in the care process. Everyone’s opinions and perspectives, regardless of their status, are valued in HRO.
Operating like an HRO can help break down traditional hospital hierarchies that often value seniority over experience.In the clinic, a attending physician Supervising interns: residents, interns and medical students.Attendees are decision makers and, historically, observations from junior colleagues – including from resident physician Often overlooked. Patients’ concerns may not be heard, whether they are intimidated or dismissed by medical staff. This means that valuable insights from junior colleagues are often overlooked in healthcare settings, undermining the standard of care for everyone, not just marginalized patients.
Additionally, HROs are aware of their actions and are characterized by a high degree of transparency and accountability.Just as airlines can rely on data to make safety decisions, healthcare companies can take advantage of 21st century Data collection and analysis Learn about the drivers of healthcare outcomes for marginalized patients.
Modeling health care after HRO can help reduce harm by standardizing how care is delivered and identifying and mitigating sources of bias that can disenfranchise marginalized patients. These sources of bias are often overlooked, or complainants may even face backlash. Unfortunately, this culture of fear and silence can have disastrous consequences.
Adoption of the HRO model may seem overwhelming, but Actionable Patient Safety Solutions (APSS), free, comprehensive patient safety courses, make it possible. These checklist protocols for hospital procedures are similar to airplane pilot procedures. APSS also addresses the cultural aspects of patient care and discusses the importance of a communication culture in which both patients and providers can voice their concerns and break the toxic culture of silence and fear.
Without efforts to make hospitals more HRO-like, the healthcare system will continue to hurt minorities.
Photo: Irina Shatilova, Getty Images
