On Medical Racism

Dr. John Hoberman discusses racial bias in the practice of medicine and medical education
By John Carranza

How has the Western legacy that divides human beings into distinct racial categories affected the practice of medicine in the U.S.? Today’s secular classification of race is grounded in the study of human anatomy. In the late 19th-century, Johann Friedrich Blumenbach, a professor of medicine, measured a variety of human skulls, from which he ascertained five racial classifications: Caucasian, Mongolian, Malayan, Ethiopian, and American. The simultaneous colonization of the Americas, driving and driven by these racial classifications, solidified the privileging of white colonists over colonized populations, engendering a racial folklore of white superiority that has been handed down through generations.

Blumenbach’s 1795 Example of Human “Varieties”

This Western racial folklore has infiltrated the theory and practice of contemporary medicine. Dr. John Hoberman, Professor of Germanic Studies at the University of Texas at Austin and 2016-2018 HI Faculty Fellow in Health, Well-Being, Healing, argues that the medical education system in the United States has been unable to correct ideas about the anatomical, physiological, and psychological characteristics of black bodies. American medicine hasn’t produced physicians who can identify racial bias in medicine, and this failure has had serious consequences for countless African-American patients. Studies show, for example, that white children are more likely than minority children to be treated with appropriate medications for their illnesses and that doctors tend to unfairly categorize minorities as overweight or obese when using the body mass index (BMI). Racial bias in medicine has established a history of distrust of the medical community among African Americans.

Dr. Hoberman employs medical liberalism as a frame for understanding the racial imbalance of power in American medicine. He defines medical liberalism as “a set of gestures, sentiments, expressions of concern, euphemisms, delaying tactics, and half-measures that aim at insulating white physicians from charges of racial bias.” Literature pointing to the fact that black patients often do not receive the same quality of care as white patients in clinical settings is published frequently, but Dr. Hoberman argues that, in spite of these studies, the medical community has taken little action. Through inaction, the racism inherent in the practice of medicine is passed down from one generation of doctors to the next.

Doctors who continue to perceive racial differences in anatomy, physiology, and psychology, a construction of race built on 18th-century pseudo-science, can cause real medical harm to minority groups, Dr. Hoberman warns. Consider a 2016 study, which found that white medical students and residents exhibit a racial bias in determining the level of pain felt by black versus white patients. This study revealed that black patients frequently receive a treatment plan that fails to help manage pain, as medical professionals tend to perceive black patients as having a higher tolerance for pain.

Particularly vexing for Dr. Hoberman and the other faculty participating in HI’s 2016-2018 Faculty Fellows Seminar in Health, Well-Being, Healing is the lack of initiative that organized medicine has shown in challenging and discarding racist beliefs. Dr. Hoberman believes, however, that medical schools such as the new Dell Medical School at the University of Texas at Austin, now entering its second year, can begin to confront racial bias in medicine by admitting more students of color. Dr. Hoberman counsels, however, that admitting students of color is not an automatic remedy for the problem of race and medicine. Medical students of color should be given the opportunity to critique the institution’s handling of race in medical education without fear of retaliation.

Dr. John Hoberman is the author of Black and Blue: The Origins and Consequences of Medical Racism.

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