A new study published in the January issue of the Journal of Pain and Symptom Management suggests doctors treat dying Black and White patients differently, showing less compassion towards terminally-ill Black patients.
The study titled, “Differences in Physicians’ Verbal and Nonverbal Communication with Black and White Patients at the End of Life,” was conducted by researchers at the University of Pittsburgh Medical Center and Purdue University.
The researchers observed 33 hospital-based physicians in the Western Pennsylvania area in simulations where they had to interact with patients (played by actors) who were dying. While the doctors knew they were being tested, however, they did not know what specific behaviors the researchers were examining.
The researchers had the doctors participate in two different recorded interactions with actors posing as patients—one Black, the other White. The patients were accompanied by family members and they all read from identical scripts. The researchers found there was no difference in the doctors’ verbal communication with Black and White patients, but there was a significant difference in the nonverbal communication with the two races.
“Although we found that physicians said the same things to their Black and White patients, communication is not just the spoken word. It also involves nonverbal cues, such as eye contact, body positioning and touch,” said senior author of the study, Dr. Amber Baranto, an associate professor of clinical and translational medicine at the University of Pittsburgh, in a statement. “Poor nonverbal communication – something the physician may not even be aware he or she is doing – could explain why many Black patients perceive discrimination in the health care setting.”
The doctors were scored on a point system for both their verbal and nonverbal communication skills when interacting with patients and family members. The physicians, who were mainly White males, averaged 7 percent lower scores for their nonverbal interactions with Black patients, compared to White patients.
The researchers found that when doctors were interacting with White patients, for example, they would stand at the patient’s bedside and were more likely to touch the invalid in a sympathetic way. When the doctors interacted with the Black patients, however, they would stand by the door holding their binder.
Such body language can give patients and their relatives the idea that the doctor is disengaged and defensive and could affect their medical decision-making, Baranto said.
“Body language is a significant tool in building trust – or mistrust – and physicians need to ensure that their body language isn’t contributing to that decision,” Baranto said. “To help Black patients and their families feel welcome and encouraged to be partners in medical decision-making, it is critical that doctors be aware of their verbal and nonverbal communication and any unintentional biases.”
