For years, when physicians order tests to assess lung function, or blood work to determine kidney function, or look up guidelines for managing high blood pressure the results have been adjusted for race. This practice has been based on studies that seemed to indicate that the same result means different things if the patient is Black vs white. So, for instance, an “uncorrected’ creatinine of 1.6 was thought to be less concerning in a Black than white patient as Blacks were thought to have greater muscle mass (not true). These correction factors masked underlying environmental and social stressors disproportionately affecting Black Americans. Regrettably they also contributed to delays in care for chronic conditions, as Black patients had to be sicker than white patients to trigger therapeutic interventions – further exacerbating disparities. We talk with two physicians who lead an anti-racism equity committee based in a Chicago VA hospital to understand the history and science that led to these “corrections,” and how they have successfully been removing them through education and advocacy across their organization and nationally. Their activism is especially meaningful because of its immediate, tangible, benefit for affected patients. The views expressed in this episode are those of the participants and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.
“Tough Love” is Not the Answer: A critique of NEJM reporting on student/trainee grievances and educator discontent
What a James Baldwin story can teach doctors and patients about care amidst suffering
How confronting racist ideas I didn’t realize I had is shaping me as a physician and a person
About me being racist: A conversation that follows an apology
Drug testing at time of birth: How physicians are co-opted into harming families while thinking they are doing the right thing
Directly and Covertly Observing Care: How it Can Transform Medical Education and Improve Clinical Practice
"Dire Consequences": When students do not receive appropriate accommodations on the USMLE examinations
Why it's time to remove time limits on tests, like the USMLE exams
Running the Gauntlet: My Journey into Medicine with a Learning Disability
Why are doctors turning to ChatGPT for help relating to patients?
Prescription Opioid Reductions and Suicide: What Should Caring Physicians Do in the Face of Uncertainty?
My patient’s in shackles: Can we take these off?
From medical student mistreatment to burnout: How can we change the culture?
Medical Student Mistreatment: A Wicked Problem
Uncommon wisdom from a family physician and medical educator
Challenging Questions to Help Physicians Reflect, Grow, and Find More Joy Practicing Medicine
Organic Chemistry and the Questionable Ways We Select and Train Physicians
Contextualizing Care in a Nutshell (and a New Study)
Medical Gaslighting: Why Are We A--holes?
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