Sometimes, it embarrasses me to be a medical professional. I honor and respect my colleagues, and typically, I’m proud to call myself a physician. But a recent Washington Post story about the enormous biases medical students have regarding pain treatment has troubled me deeply.
The Washington Post story reports that a majority of medical students at the University of Virginia believe that African Americans have less sensitive pain fibers than Caucasians. Of course, that implies that African Americans are not going to feel as much pain as their Caucasian counterparts, which likely leads to differential treatment. Unfortunately, as inexplicable as that finding is, the false belief is not limited to medical students at the University of Virginia.
Gender and Ethnic Bias in Pain Treatment
A colleague of mine reported in 2000 that in an Atlanta emergency department, 74 percent of white patients with bone fractures received an opioid, but only 50 percent of African American patients were prescribed an opioid.
Other studies have illustrated a similar cultural bias. A more recent study found that black children with appendicitis were less likely to be prescribed an opioid for their pain than white children. This was also reported in the Post article.
Additionally, black patients are less likely to be prescribed an opioid for the same pain stimulus than non-Hispanic white patients.
There is a gender bias as well. Women are less likely than men to be prescribed an opioid for a similar pain complaint. Women often are given sedatives, which presumes the pain complaint is more emotional than physical. In other words, if women are in pain, physicians tend to believe “it’s all in her head.” Therefore, their preferred treatment is to give her something to “soothe her nerves” rather than to treat the pain.
Failure of Society and the Medical Profession
As a society and as a medical profession, we have not advanced our knowledge or compassion toward people in pain, in general — and it is worse for minorities and for woman.
Therefore, it should not be difficult to understand why, today, people in pain are so frequently ignored. The biases are a part of our culture. Sadly, the medical profession owns these biases as much as society, in general, is responsible for them.
You might expect highly-trained medical professionals to have transcended bias, ignorance, and superstition. You would think that members of the medical profession would rise above prejudice.
But we have not. This is why I am embarrassed as well as disappointed.
Purchase my book The Painful Truth: What Chronic Pain Is Really Like and Why It Matters to Each of Us (available on Amazon) or read a free excerpt here.
Copyright 2016, Lynn Webster, MD