I spoke on insider-outsider status at the FEECA conference in the University of Aberdeen recently and it is very pertinent to health and healing.
We are all familiar with being part of a group (insider) and being an outsider with other groups. We know the insiders are familiar with what’s going on whereas the outsiders are not. Being an insider can have huge advantages if you are part of a public or private elite. It is rare we think of this insider-outsider status in connection with medicine, but it applies there too.
A recent study by the University of Chicago found in an analysis of more than 40,000 electronic medical records that there were troubling signs of racial bias in the notes.
The study, by a team at the University of Chicago, found that physicians appear to be much more likely to use negative words to describe their Black patients in the electronic health record (EHR) and may communicate racism through the use of words and descriptions with negative connotations.
"Compared with White patients, Black patients had 2.54 times the odds of having at least one negative descriptor in the history and physical notes," Michael Sun, a third-year medical student at the University of Chicago Pritzker School of Medicine and lead author of the study, told Medscape Medical News. "Our findings raise concerns about stigmatizing language in the EHR and its potential to exacerbate racial and ethnic health care disparities."
Previous studies have looked at stigmatizing language in medicine and bias in clinical decision support. But Sun's group said their study, published January 19 in Health Affairs, appears to be the first to quantify such language in EHRs.
The article in Medscape can be seen at https://www.medscape.com/viewarticle/966911
This is troubling but there is another area where insider-outsider status is evident and that is the area of natural medicine. It is the rare patient who will tell their biomedical health care professional that they are taking herbal medicine, going for reiki, or other energy work. They do not tell of their treatment because the medical doctor will advise them against it saying there is no scientific evidence for it. This means a patient’s holistic understanding of their health is being undermined and their experience of benefiting from other therapies is being ignored or repudiated.
Why is energy work repudiated? Because you can’t prove it in a laboratory, but is that the only valid scientific method?
