There are so many damning statistics in a piece published this week by STAT, the health and science news site launched last fall by the Boston Globe, about racial disparities in health care. Half of physicians in one survey, for example, believed at least one untrue statement implying “biological differences in pain perception between blacks and whites,” which no doubt leads directly to this next depressing stat: ER doctors are up to 30 percent less likely to give pain medication to black patients than white patients, even when the subjective level of pain reported is the same.
But the problem often starts back in med school, in which physicians receive inadequate training. Consider this example, taken from surveys of American dermatologists:
[A]lthough black Americans with melanoma, a type of skin cancer, are more than four times as likely as white Americans to be diagnosed only after their cancer has already spread to other parts of the body, half of dermatologists report that their medical schools did not prepare them to diagnose cancer on black skin. And barely 1 in 10 dermatology residencies include a rotation in which physicians-in-training gain specific experience treating patients with skin of color.
That figure – that half of dermatologists say they were not trained to spot signs of cancer on black skin – comes from research presented at a 2011 meeting of the Society for Investigative Dermatology. As far as I can tell, it was never published in a medical journal – and, that, too, is part of the problem here. As one review of the literature, published in 2012 in the journal Dermatologic Clinics, notes, “there remains a scarcity of robust basic dermatologic research examining skin of color.”