Table 2 Categories and representative quotes from free-text responses of study participants, Georgetown University 2020
From: Medical educators’ perceptions of race in clinical practice
Theme | Category | Free-text examples |
|---|---|---|
Disease risk, Diagnosis & Screening | “ASCVD risk calculators use race to calculate 10-yr risk…HbA1C results in an African American patient need to be interpreted with caution if utilizing for screening for DM…GFR and Cr normal value ranges are different for differ races. Same for screening PSA values, and WBC count” | |
1 | “Certain pre-/disease conditions, such as sickle cell or BRCA-related breast/ovarian cancers, occur predominantly in people of particular ethnic/racial backgrounds. To ignore or minimize these realities would be a disservice to affected individuals of those backgrounds” | |
Treatment of Disease | “Individuals of a certain race may respond better to a specific class of medications (Ex. CCIs are more effective for African Americans when treating HTN)” | |
1 | “Need to understand if people of some races have a propensity to toxicities from certain treatments | |
Patient Counseling | “If a disease, such as HTN or DM is more prevalent in a population, whether by race, or geographic distribution. More attention should be paid toward educating the patient” | |
1 | “Genetic predisposition to scar has a racial component - understanding that is important in counseling patients about expected outcomes” | |
Acknowledging Racism | “It is important to consider self-identified race when considering the impact of structural and systemic racism as an environmental stressor. Also, given the historical trauma that certain communities have been through (e.g. Tuskegee experiments, covert sterilization of Black men and women, etc.), it is important to understand how this may have shaped the relationship between those communities and the medical establishment.” | |
2 | “It is important because it has been well documented now that race has a large role in clinical outcomes. Patients with the same disease but different races will experience vastly different interactions with medical professionals. As such, race has to be involved in making clinical decisions in order to start the process of reducing the influence of unconscious and conscious bias” | |
Understanding Socioeconomic factors | “Helps to understand other barriers to care/ability to complete care plans” | |
2 | “Not all groups have same access to health care, insurance, drugs/therapies” | |
2 | Acknowledging Cultural Factors | “Understanding how cultural identification influences understanding & compliance with therapy” |
“Pain is described very differently in certain cultures” |