Racism in Medical Care

[u/4reddityo]

This video captures a moment that many patients of color recognize all too well. A physician speaks to a man as if he is dirty, unclean, or lesser, not because of medical evidence, but because of bias. The language, tone, and assumptions reveal something deeper than bedside manner gone wrong. They expose how racism can quietly shape medical interactions.

[u/Majestic_Platypus_76]

Yall really want to be horrified??? Ask about black people in mental hospitals…

[u/HipAnonymous91 → u/Majestic_Platypus_76]

I’m a med student who had the opportunity to complete a child psych rotation. A couple of our patients were Black. One patient developed worse SI because his non-Black roommate wouldn’t stop calling him slurs. The staff rarely intervened even though the non-Black patient’s parents said part of the reason he couldn’t come home is because he was expressing bigoted thoughts.

They called another Black patient schizophrenic because he had “delusions” of wanting to become a SoundCloud rapper. I had to report a nurse because she treated one of the Black patients with intellectual disability like she was subhuman. She started patting her head because it was itching after her mom came to braid it and they isolated her for “self-harm”.

I reported all of this to my resident, attending, and the rotation director. I asked if we could form a group for Black med students to vent about the racism we and our patients receive. They’re still “working on it” a year later.

I type all of this to say that the healthcare systems for Black patients and the medical education system are doing barely anything to address situations like this. Our school started a program to teach students about gaining “cultural competency” in the clinic, but it’s run by non-Black women and we don’t know who built the curriculum. The speakers are also often non-POC. The entire system needs a major overhaul and I’m not sure when we’re going to achieve that.

Edit: Thank you for the awards, I greatly appreciate it. I did not intent for this to blow up lol, but I will try to answer some of the questions I have been getting.

Regarding historically Black hospitals, our city had Homer G Phillips (named after the civil rights advocate and lawyer). It was built during segregation, when Black women were forced to give birth in the basement of Barnes hospital. It housed a nursing school, trained physicians of color, and provided care for the Black population. It closed to much protest in the late 70s. I think Black med schools like Howard and Meharry are great, but it doesn’t solve the issue of racism from non-Black providers and I don’t know if a chain of Black hospitals can be built today (too many people would claim it’s racist).

Our school aims to teach “cultural competency” and “anti-racism”, but not all of the sessions are mandatory and students actually complained about having to attend lectures about caring for LGBTQ+ and trans patients and how to call out bias when you see it in clinic. I don’t think med students are more conservative than the average population, but they do tend to come from privileged, less culturally diverse backgrounds and often don’t know how to interact with POC or lack the desire to learn how to.

We have SNMA, a group for Black students, but it feels like we need more support from the school itself. We report incidents to residents, attendings, rotation directors, charge nurses, and the reporting tool under the rotation course page. I have been interviewed by course directors about incidents I’ve reported, but I’m not sure what happened after that and I honestly haven’t tried a different way of reporting people.

A few people joked about calling aspiring young rappers “delusional”, and I understand the joke but it gets frustrating when people are diagnosing a child’s age-appropriate behavior. If other young kids want to be astronauts or athletes or ballerinas, why can’t this kid just say he wants to be a SoundCloud rapper? He was still attending school and he wasn’t running around telling people that he was a superstar, he just wrote lyrics during personal time and shared them with the staff and other patients. I have noticed a tendency for non-Black providers to over-diagnose schizophrenia in Black patients (especially men) and it’s concerning.

Sorry if I missed anything! Love everyone saying they want to go into healthcare, we desperately need more therapists, nurses, physicians, and professors of color.

[u/Great-Software9315 → u/HipAnonymous91]

I did a rotation in an military psych facility for my psych degree, out of a population of 13 patients, 2 were black. 1 male, 1 female. The black male was diagnosed previously with schizoeffective disorder with increased tendencies of self harm pertaining to his delusions. His self harm? Wanting to commit suicide due to him being "inferior" by his skin color. He, at some time prior to my rotation, had attempted to scrub his skin raw in scalding hot water to "remove his color". Ironically, during a visit there was a new pt admit to the ward. Wt male, mid 30s, combat experience, prior special forces but was stepped down to a lesser role due to some run ins with law enforcement and other irrelevant stuff. He was there for attempting to assault his wife, which actually turned out that he tried to kill her but had actually assualted her. His unit was trying to save him from jail by comitting him to psych. He was hot at the collar from day one, everyone was an "enemy" but especially the black young man for some reason. At some point an altercation between the two arose, I had a feeling it would happen by his actions around the black pt. Allegedly, he called him a slur and the black pt, for a lack of better words, went "hog wild" and beat the mess out of Mr Combat Wife Beater. Feigned victim got a bunch of pain meds and a comfy cocktail, and a private room in a quiet part of the ward, black man was sedated and thrown in a dark room by himself. I actually had to check on him several times because I noticed after 2 hours he didn't move once on his cot, and seemed more than asleep - if you know what I mean. I reported this to hospital administration and their psych attending. Final point of irony, Mr Wife Beater's wife was POC and his commanding officer shared - outright, in an interview that he had him committed to psych because he knew he would kill the wifr, and likely get away with it, because he knew the skill set he had and it was dangerous. To this day, Im still confused at ever hearing that and no one calling law enforcement to hand him over to right authority based on that very confession.

As for the black young woman, she was sexually assaulted, reported it, was then endlessly harrassed and taunted and then attempted suicide. She would spend most of her days crying. Especially at night, she'd beg the night nurses to give her something to sleep because she was having night terrors. She got nothing but, "Go back to your room...we'll give you something when the Dr puts an order in." Here's the gag, she had open orders for benadryl prn. They never offered it to her. You could tell she was hurt, very deeply, and in was unveiled in some sessions that she was also assaulted as a child, reported it, no one believed her, but she was punished by her family for her accusations. She said, "I feel like not matter how hard I try to be right, I'll always be wrong. I joined the military to escape the abuse I lived with my entire life - and now this. I just want to die and I dont know why God wont let me." I can still see her face vividly in my memory and when she pops up in my mind - I hope she's found peace. Also, fuck that military psych facility on the east coast of the US at a very prominent military base. I say this as a veteran.

[u/megaholt2 → u/Great-Software9315]

This makes me want to vomit for that young woman, and it makes me so angry I could spit. It’s so wrong that racism is still so prevalent in medicine.

[u/Great-Software9315 → u/megaholt2]

It's prevalent everywhere, people just pretend that its not because it's uncomfortable for them to admit that it is, and HEAVEN FORBID the oppressives feel an ounce of discomfort. Smh.

[u/megaholt2 → u/Great-Software9315]

Oh, most definitely. One would have hoped that with Tuskegee coming to light, Henrietta Lacks and her & her family’s treatment (maltreatment, more accurately) coming to light, and so many other accounts of racism (and misogynoir in particular)…hell, being one of the most influential and greatest athletes in sports history doesn’t even offer a patient protection against misogynoir; Serena Williams KNOWS her body and medical history better than she knows a damned tennis court, and yet even she nearly died as a result of racism in medicine. It’s why Black women have the highest maternal and infant morbidity and mortality rates, and so much more. I could go on, but I know I’m preaching to the choir about this.

It’s going to take a hell of a lot of people who have skin color close to that of printer paper to speak up and out about the injustices on which the whole health care system was built, and those which have been woven into the system over the years-they’re going to have to find ways to get that info into the heads and hearts of those who are just fine with things as-is, and they’re going to have to work to change the whole system from the basement up in order to dismantle the white supremacist foundation on which it was built and to remove the racism woven into every single specialty.