Some Advice for Physicians and Other Clinicians Treating Minorities, Women, and Other Patients at Risk of Receiving Health Care Disparities.
Studies of inequalities in health care have documented 13 groups of patients who receive disparate care. Disparities are partly due to socioeconomic factors, but nonsocioeconomic factors also play a large contributory role. This article reviews nonsocioeconomic factors, including unconscious bias, stereotyping, racism, gender bias, and limited English proficiency. The authors discuss the clinician's role in addressing these factors and reducing their impact on the quality of health care. They indicate the significance of cultural humility on the part of caregivers as a means of amelioration. Based on a review of the clinician's role as well as background considerations in the health care environment, the authors put forward a set of 18 recommendations in the form of a checklist. They posit that implementing these recommendations as part of the patient clinician interaction will maximize the delivery of equitable care, even in the absence of desirable in-depth cross-cultural and psychosocial literacy on the part of the clinician. Trust, mutual respect, and understanding on the part of the caregiver and patient are crucial to optimizing therapeutic outcomes. The guidelines incorporated here are tools to furthering this goal.
Harvard Medical School, Boston, MA, USA. Augustus_white@hms.harvard.edu.
Augustus A
AA
White
The Center for Culturally Fluent Leadership, Newton, MA, USA.
Beauregard
B
Stubblefield-Tave
D054521:Cultural Competency; D054625:Healthcare Disparities; D006801:Humans; D008913:Minority Groups; D010817:Physician-Patient Relations; D010820:Physicians; D063505:Racism; D012959:Socioeconomic Factors; D013240:Stereotyping; D014930:Women
Conscious bias; Cultural competence; Cultural humility; Equitable care; Health care; Health disparities; Health equity; Implicit bias; Microaggressions; Minority health; Patient clinician relationship; Patient empowerment; Unconscious bias; Women’s health