Having a doctor who shares the same race may ease patient's angst
New research suggests that Black patients may have less pain and anxiety
when treated by a physician of their own race

Date:
August 24, 2020
Source:
University of Miami
Summary:
When doctors are the same race as their patients, it can sometimes
forge a sense of comfort that helps to reduce anxiety and pain,
particularly for Black patients, new research suggests.



FULL STORY ==========================================================================
When doctors are the same race as their patients, it can sometimes forge
a sense of comfort that helps to reduce anxiety and pain, particularly
for Black patients, new research from the University of Miami suggests.


==========================================================================
In a study recently published in the academic journal Pain Medicine,
and led by Steven R. Anderson, recent psychology Ph.D. graduate,
and Elizabeth Losin, assistant professor of psychology, groups of
non-Hispanic white, Hispanic, and Black patients participated in a
simulated doctor's appointment. Patients were given a mildly painful
series of heat stimulations on their arm by a medical trainee playing
the role of a doctor to simulate a painful medical procedure.

Participants indicated how intense their pain was throughout the procedure
and researchers also measured the patients' physiological responses to
the painful experience using sensors on the patients' hands.

Some of the patients were paired with a doctor who identified as the
same race and ethnicity as they did, which is called "racial/ethnic concordance," while others were not. After the experience, researchers
compared the pain levels of the group paired with same race/ethnicity
doctors with those paired with a doctor of a different race/ethnicity. The
most intriguing results came from the Black patients who were paired
with Black doctors.

"Black patients paired with Black doctors reported experiencing less
pain across several types of measures than Black patients paired with
Hispanic or non-Hispanic white doctors," said Losin, who leads the Social
and Cultural Neuroscience lab.

Additionally, Losin said that data from the sensors showed the Black
patients' physical responses to pain were also lower when they were
paired with a doctor of their own race.

"This provides some evidence that Black patients were showing a benefit
of having a doctor of their own race at multiple levels -- showing pain
relief in both their communication and their physiology," Losin said.



==========================================================================
The idea to investigate the role of racial concordance in the
doctor-patient relationship came from previous research that shows that
there are major disparities between racial and ethnic groups in terms
of the level of pain experienced from medical conditions and procedures, according to the researchers.

Typically, Black and Hispanic populations report more pain from medical conditions and in pain research studies, compared to non-Hispanic white populations. Also, previous research has suggested that when a patient
has a doctor who shares their demographics in terms of gender, race, or language, it can influence peripheral health outcomes like the patient's satisfaction and their adherence to medication. That led Losin's team to investigate whether racial/ethnic concordance between doctor and patient
would go deeper to affect the patient's pain level as well.

"There are fewer studies about doctor-patient concordance and its effect
on direct health outcomes like pain," Losin said.

To understand why Black patients experienced reduced pain and pain-related bodily responses with a doctor of the same race, the researchers delved
into some of the introductory surveys given to the patient participants, Anderson noted, and found a big clue.

"The factor that really differentiated the Black patients from the other
groups was that Black patients were much more likely to say they had experienced racial or ethnic discrimination or were currently concerned
about it," he said.



========================================================================== What's more, the Black patients who reported experiencing and worrying
more about discrimination showed the greatest reductions in their bodily responses to pain when they had doctors of their own race, Anderson said.

"Together these findings suggest that perhaps one reason why Black
patients may have had a reduced physiological response to pain when they
had Black doctors was because they were less anxious about the possibility
of being discriminated against," Losin said. "We know that anxiety
is closely tied to pain." Although non-Hispanic white and Hispanic
patients were included in the study as well, whether or not they had
a doctor of their own race didn't seem to make a difference for their
pain. This was what the study authors expected for the white patients
but found surprising for Hispanic patients, who also have been found to
report more pain than non-Hispanic whites in previous research studies.

One possible reason Hispanic patients didn't show the same pain reduction benefit of having an own-race doctor as Black patients did, is that
on average the Hispanic patients didn't actually perceive the Hispanic
doctors to be more similar to them in terms of their race or ethnicity
than the Black or non- Hispanic white doctors. This is likely due to the
high cultural and national heterogeneity among Hispanic/Latino Americans
and suggests more research is needed into what factors related to the doctor-patient relationship may help decrease pain for Hispanic patients.

Losin and Anderson said their study highlights a potential benefit of
having more Black physicians in the medical profession: it could mean
a reduction in pain disparities.

As of 2019, only around 5 percent of physicians identified as African
American and Hispanic respectively, which means that most Black patients
will rarely get to experience the benefits of seeing a physician that
looks like them and understands their life experiences.

"Physician diversity initiatives are often seen as beneficial for
improving patient comfort and satisfaction, but with our study we have
evidence that there may be direct health consequences to not having a
diverse work force as well," Anderson said. "Our study speaks to the
importance of physician diversity in improving health outcomes."

========================================================================== Story Source: Materials provided by University_of_Miami. Original written
by Janette Neuwahl Tannen. Note: Content may be edited for style and
length.


========================================================================== Journal Reference:
1. Steven R Anderson, Morgan Gianola, Jenna M Perry, Elizabeth
A Reynolds
Losin. Clinician-Patient Racial/Ethnic Concordance Influences
Racial/ Ethnic Minority Pain: Evidence from Simulated Clinical
Interactions. Pain Medicine, 2020; DOI: 10.1093/pm/pnaa258 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/08/200824144315.htm

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