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Researchers explore doctors' cultural bias, treatment of poor

We all buy into one stereotype or another. It can be as simple as thinking that someone who dresses in ragged jeans and a tattered sweatshirt couldn't possibly pay for all the groceries in his cart. For health care workers, though, that unconscious bias can result in a hasty, improper diagnosis or worse. Patients who look indigent can be ignored or dismissed altogether -- because the doctors or nurses think they will not be paid.

The results of a recent study showed that doctors may not suffer many consequences for that bias. Researchers found that poor people are less likely to sue for medical malpractice than patients with money are.

It is a surprising conclusion for a number of reasons, not the least of which is that doctors tend to believe the reverse is true. According to the study's authors, physicians may be reluctant to treat poor patients because they believe those patients are more likely to sue.

The researchers analyzed existing malpractice claim and litigation data and compared the results for low-income patients to groups in other income tiers. Not only did they discover that low-income people are less likely to sue, but they also discovered why: This sector has little access to legal resources and insufficient funds to file suit.

The authors assert that the medical community can address the problem. Medical schools and care systems can train doctors how to deliver "culturally competent care." Cultural sensitivity programs have been successful in the health industry, so it makes sense to encourage their adoption everywhere.

Some of the responsibility should be shifted to the patients, too, the authors say. Patients must learn to take an active part in their own health. Again, patient involvement has been proven successful.

Success is measured not just by a reduction in litigation or medical malpractice claims. The proper combination of cultural competence and patient involvement can lead to better care and higher satisfaction for both physicians and their patients. It can also eliminate bias in the delivery of health care -- bias based on gender, race, ethnicity, sexual orientation or socio-economic status.

Source: MSN.Health, "Poor Patients Less Likely to Sue Doctors, Analysis Shows," Mary Elizabeth Dallas, Feb. 28, 2012

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