How Long Can This Theory Last?
on September 1st, 2009 at 7:51 amBlack hypertension patients experience poor communication with doctors than white patients
Participants in Cen-’s study included 226 Hypertension high blood pressure patients and 39 physicians from 15 primary care practices in Baltimore. Coders listened to recordings of the patient visits and measured several outcomes. These included, but were not limited to, the length of visits and the number of statements devoted to the communication functions of biomedical exchange, psychosocial exchange and rapport building.
The results showed that the black patients had shorter office visits, less biomedical and psychosocial exchange and less rapport building with their doctors than white patients. These differences were statistically significant for psychosocial exchange and rapport building but not for biomedical exchange. Blacks with uncontrolled Hypertension high blood pressure fared somewhat worse than blacks whose blood pressure was controlled by medication, whereas there were no significant differences among whites based on blood pressure control status.
The researchers found that for each outcome blacks, regardless of whether their blood pressure was controlled or not, had worse communication with their doctors than whites, regardless of the white patients’ blood pressure control. The only exception was for an outcome called “patient positive affect,” which is a sum of ratings of patients’ interest, friendliness, engagement, sympathy and assertiveness behaviors. For this outcome they found that blacks with uncontrolled blood pressure had less positive affect than any of the other groups.”
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“We believe there also may be an ‘unspoken subtext’ that occurs in visits between patients and doctors that influences the communication that occurs during the visit,” Cen- said. “It’s possible that black patients are more likely to pick up on that ‘unspoken subtext’ and it alters their communication with their doctor. This might explain why we found that black patients had less positive affect towards their doctors than white patients. Essentially they are more sensitized to ‘cue’ into things that the coders could not easily capture just by listening to the audiotapes.” (more…)
A few thoughts:
# I’m not buying this notion that in 2009, a significant number of Black folks do not ask questions because of some unspoken racial component. While I would readily admit that many doctors these days do not voluntarily give out additional information, much of this is based on the type of insurance the patient is under. The lower the insurance plan, the less time the doctor is going to spend with the patient. Universal health care will not fix this problem. It will only make it worse.
#Unrelated but related: Folks have also peddled this same theory (Blacks are too scared and racially intimidated to ask questions) in the housing market. Same goes for payday loan guidelines. Same goes for computerized voting machines. When will we see a study that explores whether or not Blacks are too scared and racially intimidated to ask questions about things like cell phones, iPods and other electronic devices, cars, speaking with waiters, etc.? You will never see it? Why? Because it does not fit the narrative.
#Based on what was presented in this article, there is an assumption being made that the doctors themselves were White. What was the racial makeup of the doctors? Are we to also assume that doctors in general throughout Baltimore are racist–even if they are non-White?
# Not following medical advice
