Thank you for the articles. And thank you NA and Lucy for your experiences. I do not discount anybody’s personal experience with others and how it made them feel. But it cannot be proven that an individual’s experience was different because of their gender/ race/whatever. All that exists is one’s feelings. I do not buy into the belief that bias seeps into every aspect of life. My anecdotal data is that some doctors treat me and my wife as one size fits all, and they only adjust when we support our concerns with our own research or knowledge. Other times the doctor simply “doesn’t listen” to what we had to say. Had I been black, perhaps I would attribute this to being black.
There was a case of an OBGYN procedure that was touted as a “simple procedure” from a male doctor, which might be the case for him, but was far from it from my wife’s perspective. Other male OBGYN experiences have been fine.
I fully read the U of Oregon study. I do believe that in the aggregate, people will treat “similar” people differently than those that are different. Again, I’m saying in the aggregate. And there are those that also go out of their way to treat those “different” than them better (or more thoroughly) than those that are “similar”. This particular study admits that “physician gender and ethnicity were unavailable in the dataset and therefore not included in statistical models”. It was a solid attempt at a study at one hospital (in Boston) with a priori predictions of gender and racial bias, as well as a statement of “fact” that “these biases are pervasive across many societal domains including politics, employment, and medicine.”
I found flaws in some of the conclusions given by the author, and I admit that I would likely find flaws with a study that predicted gender/racial biases could be explained by other patient characteristics (income, literacy, prior experiences, overall education, medical knowledge, etc.). This study is part of a larger problem with widespread diversity initiatives that are misapplied by reducing all diversity down to gender and race without recognizing the multi-faceted diversity of each one of us. The end goal of (perceived) equity or equality is an impossibility given this laziness from the distortion of definitions.
tl;dr - not all doctors are equal, negative experiences are not all because of bias
The “today” article from Ajstudies is an anecdotal emotional appeal.
The ABA article raises some good points if you proceed to the Institute of Medicine article. I do believe that in the aggregate, black people receive worse medical care than white people. The ABA article claims this is the case after adjusting for poverty and other factors. The author of the ABA article assumes significant implicit bias exists, and she recently wrote a book is titled “Critical Race Theory: A Primer”. I will not be convinced by her, but I will dive more into the IOM article.
I remain unconvinced by any piece of anecdotal data; I feel I have been discriminated against by a few black females in doctor’s offices because of my race or gender. It does not mean that I was, it could simply be because they were awful or had a bad day(s). Their more positive treatment of a black female patient that I witnessed could have been due to a variety of reasons.
The last one has a lot of links to other studies which I’d also encourage you to review.
From the first link:
These links are but a drop in the bucket of overwhelming evidence that racial disparities exist in how patients are treated… even when controlled for other factors like insurance and symptoms.
You can choose to ignore the research if you want, but your statement is demonstrably false.
I got sick of doctors telling me I didn’t have a thyroid problem given my TSH was normal, so I did an at home Let’s Get Checked test and voila, T4 levels were too low.
Symptoms can be subtle or not severe enough for a doctor to point them out to you - like for example my cholesterol levels were always borderline high, I was sensitive to cold, couldn’t lose weight, etc.
No, it can’t be rigorously proven. That doesn’t mean it’s not true.
Fwiw, i am the daughter and granddaughter of doctors, and i speak “doctorese”, and i actually think i get better care than average (most of the time) as a result of that. I am certainly not claiming some monolithic experience that is true in every case for every woman (black, etc.) But look at the case of Serena Williams. I found a better article at the time, but this one is okay
She had a pre-existing condition and knew what was wrong and the doctors ignored her for long enough that her life was endangered.
The mortality of Black women giving birth in America is higher than that of white women, after adjusting for socioeconomic status.
A whole lot of other medical outcomes are worse for Black Americans.
No, you can’t prove bias in any particular case. But when the trends are striking enough, an actuary ought to take note. Instead, i find people spend all their energy trying to come up with alternative explanations.
Yeah, anecdotes aren’t proof. That’s why i pointed to STANDARD TREATMENT for two short, uncomfortable procedures. What’s the medical reason to sedate people for a colonoscopy?
Thank you for the links. I will agree that the assessment of pain in blacks and whites is different (by white people), and therefore pain treatment. I have only read the PMC article, but Study 2 supports this and I believe I would find enough evidence in the other links. I disagree with the implementation of Study 1, as misconceptions about race were presented only one-sided. For example, the question that “(Do) blacks age more slowly than whites” can only be answered yes/no. Had the question been worded “(Do) whites age more slowly than blacks”, there would have been some agreement with that (false) statement the other way. The study was only set up to conclude that a sample of the group “seemed to assume that the black body is stronger and that the white body is weaker” or no difference. The study could not have come to the (false) conclusion that the “white body is stronger” due to the setup.
Regardless, my statement that you quoted is logically accurate and is not demonstrably false. You infer something more from my statement that you quoted. One cannot prove that an individual’s treatment was different because of race. In order to prove my statement as false, you need to make the leap that EVERY black person’s treatment is different (worse) because of race. This is not close to true.
Do you think every young man is a worse driver than every middle aged man?
Of course not. But actuaries all believe that “young men are worse drivers”, and the rating systems we create reflect that belief.
Why work so hard to dismiss the evidence that Black people, on average, get worse medical care? That women’s pain is discounted as compared to men’s pain?
Naw, there’s a lot of evidence that there’s significant bias in medicine.
While you may not be able to prove beyond a reasonable doubt that any one incident is due to bias rather than incompetence… when there’s an especially egregious case it’s reasonable to assume that bias played a role given that we know it exists and have been able to quantify it.
Did I post the one about the black man with three broken ribs being sent home and told he was fine?
This is what became enlightening for me during COVID treatments. I was assuming socioeconomic was the primary factor, and it may be, but well beyond that
Thanks for understanding my point/logic in your previous post. As I stated in my full post, I did not work hard to dismiss evidence as shown by my agreement with white people’s perception of pain in black people. I work hard to find flaws due to bias in studies. Discrimination exists, but I do not seek to ascribe everything as discrimination. Society will not get anywhere this way.
I cannot fully answer the IUD/colonoscopy sedation argument. Anecdotally, I do know that my wife, after the procedure, could not understand why sedation was not involved with a particular OBGYN procedure.
I believe that inexperienced drivers are worse than experienced drivers, which lends itself to young men(women) being worse drivers in aggregate than middle-age drivers.
My threshold is not proof beyond a reasonable doubt. I disagree that it is reasonable to assume that bias plays a role in any egregious case. In many cases, people want to see bias because it supports their mindset.
You bring up more anecdotes. I have had experiences with (white) children in the ER where doctors drew incorrect conclusions where I had to fight for hospital admittance. However, I have too many negative opinions about US ER medicine in general to mention here.
I have benefitted from the discussion, so thanks again. Time to work!
Viewing everything as discrimination and ignoring it are both very damaging. There is no permanent fix to some discrimination. It is currently set up to be a perpetual issue with limited true dialogue. It has been monitized. Unfortunately, that is the way things are in the social media world. Logic and debate are simply shouted down. The internet and written forums are far from ideal ways to argue important issues.
I weigh over 30 pounds less than I did 10 years ago and sometimes wondered if it was overactive thyroid issues rather than my eating habits changing that drastically. I seem to still be losing weight now. Didnt care about being a low weight until this debilitating fatigue became an issue.
Although my tsh levels were low normal. I’d think for an overactive thyroid it would be high normal if anything. So idk.
My cholesterol is on the high side but not sure that’s related.
I’m not sure my feelings on hot or cold differ enough from the norm to count.
I finally decided to reach out to my primary care physician one more time after she was entirely useless when I saw her in September. I sent her a long message.
THIS WAS HER FUCKING REPLY. ARE YOU FUCKING SERIOUS? I DON’T NEED YOUR SYMPATHY. I NEED YOU TO ACTUALLY DO YOUR JOB.
"so sorry to hear this. i think it would be smart to see an endocrinologist. i imagine seeing someone at home would be smart. "
so, now I need a new primary care physician since she is beyond useless.
Seemed to be since it was confirmed at the doctors after I showed him the results. They don’t normally run the T3/T4 tests unless they suspect there’s a problem - they just look at TSH and go “yup, normal, go away”).
Overactive thyroid is actually associated with a low TSH, and underactive with high (I have the latter). It seems counterintuitive at first, but the fact is that if your thyroid is overperforming it means it doesn’t need as much TSH to stimulate it (and vice versa).
