A doctor's body language may reveal racial bias against seriously ill black patients, a new study suggests.
The finding could help explain why dying black patients are much more likely than whites to ask for more extensive life-saving measures and to report worse communication with their doctors, the researchers said.
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"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 study author Dr. Amber Barnato.
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"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," said Barnato, an associate professor of clinical and translational medicine at the University of Pittsburgh School of Medicine.
However, the study wasn't designed to show a cause-and-effect relationship; it was only able to show that communication differences exist.
The study was published in the January issue of The Journal of Pain and Symptom Management.
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The study included 33 hospital-based attending physicians. Black and white actors were asked to portray patients dying from advanced stomach or pancreatic cancer. Their scripts were identical.
The doctors' scores on nonverbal interactions were 7 percent lower when dealing with black patients than with white patients, according to the researchers."When explaining what was happening and what the next steps for care could be, with the white patients, the physicians were more likely to stand right at the patient's bedside and touch them in a sympathetic manner," Barnato said in a university news release.
Something as subtle as a doctor staying near the door and holding a binder in front of them might be perceived by patients and their families as defensive or disengaged, Bernato said. This could lead patients to ask for more extensive life-saving measures because they don't believe the doctor has their best interests in mind when suggesting less aggressive care, she suggested.
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"When you survey people in the community about their feelings on end-of-life care, blacks are only slightly more likely than whites to say they want aggressive, life-sustaining measures when terminally ill," Barnato said in the news release.
Yet, when faced with that decision in the hospital, blacks are much more likely than whites to request such care, she added.
Doctors need to be aware of their verbal and nonverbal communication, as well as any unintentional biases they may be communicating. Doing so may help black patients and their families feel welcome and encouraged to be partners in medical decision-making, Barnato explained.
"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," she said.
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