I was surprised by this article. And the nuanced effect of what your doc writes up in your medical records.
I've actually seen seen positive signalling in mine. But I can have smart mouth on me. I could easily see in insecure doc give some negative signalling.
If you are a minority or a member of any marginalized or discriminated against group, I think maybe it is important to keep your antenna alert to this problem.
Embedded bias: How medical records sow discrimination | News-Medical
As long term Prostate Cancer patients, our medical records become important and follow us around for the rest of our lives.
This can be troubling if you are a minority, or a member of any other discriminated against group.
And a bad relationship with a prejudiced or judgmental doc can cause you hidden problems later.
I have some thoughts on how to counteract or neutralize this problem, but I would like to hear your thoughts first.
(Warning - this article doesn't refer specifically to prostate cancer)
The stereotypes that can find their way into patients' records sometimes help determine the level of care patients receive. Are they spoken to as equals? Will they get the best, or merely the cheapest, treatment? Bias is "pervasive" and "causally related to inferior health outcomes, period," Matthew said.
Narrow or prejudiced thinking is simple to write down and easy to copy and paste over and over. Descriptions such as "difficult" and "disruptive" can become hard to escape. Once so labeled, patients can experience "downstream effects," said Dr. Hardeep Singh, an expert in misdiagnosis who works at the Michael E. DeBakey Veterans Affairs Medical Center in Houston. He estimates misdiagnosis affects 12 million patients a year.
Conveying bias can be as simple as a pair of quotation marks. One team of researchers found that Black patients, in particular, were quoted in their records more frequently than other patients when physicians were characterizing their symptoms or health issues. The quotation mark patterns detected by researchers could be a sign of disrespect, used to communicate irony or sarcasm to future clinical readers. Among the types of phrases the researchers spotlighted were colloquial language or statements made in Black or ethnic slang.
"Black patients may be subject to systematic bias in physicians' perceptions of their credibility," the authors of the paper wrote.
That's just one study in an incoming tide focused on the variations in the language that clinicians use to describe patients of different races and genders. In many ways, the research is just catching up to what patients and doctors knew already, that discrimination can be conveyed and furthered by partial accounts.
Confer's MedStar records, Cohen thought, were pockmarked with partial accounts — notes that included only a fraction of the full picture of his life and circumstances.
Cohen pointed to a write-up of a psychosocial evaluation, used to assess a patient's readiness for a transplant. The evaluation stated that Confer drank a 12-pack of beer and perhaps as much as a pint of whiskey daily. But Confer had quit drinking after starting chemotherapy and had been only a social drinker before, Cohen said. It was "wildly inaccurate," Cohen said
Embedded bias: How medical records sow discrimination | News-Medical
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