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Washington, D.C. - February 08, 2011 - Dr. Augustus
White, with a group of nuns at a Leper Colony in Vietnam in the late
1960s, as he was becoming increasingly aware of medical discrimination
against minorities.
When Augustus White was growing up in the American south in the
1940s, racial segregation was an accepted part of life. African
Americans got second best - in education, employment, and health care.
But White overcame those barriers, becoming an
orthopedic surgeon, professor of medicine at Harvard and a leading
figure in the struggle to reduce discrimination against minority medical
patients.
Overcoming barriers
White was the first African American to reach a
series of academic and professional milestones that were unheard of in
the 1950s and ‘60s. The first African-American president of his
traditionally white fraternity at Brown University, White was the first
African American to graduate from Stanford Medical School, the first
black resident, the first black surgery professor - at Yale University -
and the first black department chief at Harvard’s teaching hospitals.
But what White may be best known for is his groundbreaking exploration
of the deeply-rooted bias against minority patients that he believes is
prevalent in the American health care system.
Struggle for medical equality
White first became aware of discrimination against
minorities at the start of his medical career in the early 1960s and,
later, while serving as a combat surgeon during the Vietnam War. His
personal observations were further confirmed when he read a 2002 report
that revealed some disturbing statistics about discrimination, not only
against blacks, but also women, Hispanics, gays, the elderly and even
the obese.
"This Institute of Medicine report, "Unequal Treatment," just spells it
out in just blatant, statistical, overwhelmingly convincing ideas and
realities about this inhumanity that exists," he says.
It’s conscious and unconscious, says White, but it’s a prevailing
situation. "When are you most vulnerable? It’s when you’re sick. And to
realize that under those circumstances you’re at risk to receive
disparate care is really quite an issue."
Unequal treatment
The report also cited that African Americans
receive less pain medication for the same injuries than white Americans;
women dying from kidney disease are less likely to receive transplants;
Hispanic Americans receive less angioplasty and bypass surgery for heart
disease than whites; and the elderly are treated as less valuable than
younger patients.
White finds this shocking, and inexcusable. "It’s a moral issue. It’s a
legal issue. It’s a public health issue. This is a question of human
rights," he says. "People should be getting the best care that the
profession can offer them. And now they’re not getting the best care the
profession can offer them."
What was even more surprising to White was seeing just how unconscious
this bias seemed to be.
"There are examples of female doctors actually giving disparate care to
female patients. There are examples of African-American doctors actually
giving disparate care to African-American patients. And my theory is
that the culture of medicine is so powerful that when you come through
it as a student and as a resident and as a young doctor, and you get
inculcated into the profession, sadly, part of that momentum includes
these biases."
Medical inertia
To counteract these discrepancies, White calls for
changes in education for doctors, nurses, medical school faculty, even
insurance companies. He says they need training in self-awareness, so
they can recognize their internalized prejudices, and be able to work
from that.
White believes doctors need to understand the culture their patients
come from - something he calls cultural literacy.
"Medical students should be taught something about the characteristics
of the cultures that they may be treating in large part. So if 30
percent of your patients are Muslim patients, you should have some
insight, some idea about what some of the prevailing practices of the
Muslim culture may be."
With a new book about his experiences, called "Seeing Patients -
Unconscious Bias in Health Care," White hopes to make the medical
community aware of the problem, and trusts it will motivate them to
doing something about it.
But he admits that it’s going to be a challenge.
"There is a kind of denial, there is a kind of inertia, but I think this
is a mission that deserves a lot of energy and enthusiasm to get medical
schools to be more committed with resources, with determination, with
sustained efforts to really change the culture of medicine."
White remains hopeful that change will come - and that everyone will
have equal access to the best medical care the nation can provide.
On the Web
This article originally appeared on
VoANews.com. |
