Much has been written about the doctor-patient relationship and its many challenges and ramifications.1 However, almost nothing is written about the effects of race on this relationship. This is unfortunate, since we live in an era of increasing concern for community medicine and for improving the delivery of medical care to all people. In discussing the effects of race on the doctor-patient relationship, our aim must not be merely to accuse or to place blame but to analyze critically the problem, with the goal of improving medical care delivery. Our silence on this issue tends to deny that we see racism as a major barrier to good medical care for many people in our society. We live in a racist society, and all around us the forces of racism help to determine the course of our lives and the nature of our relationship.2 Unfortunately, racism knows no geographic or academic boundaries. One need only look casually at the medical profession to see how potent a force racism has been in its development. It was primarily the discriminatory practices of local chapters of the American Medical Association that led to the birth of the predominantly black National Medical Association (NMA) in 1895—13 years before the founding of the National Association for the Advancement of Colored People (NAACP).3 As late as 1968, a careful evaluation showed that while the black population was approaching 13% in this country, only about 2% of physicians were black, and of these, 50% had been trained at our two predominantly black medical schools—Howard University in Washington, DC, and Meharry Medical College in Nashville, Tenn.4 It certainly seems that despite superior academic training, the medical profession has been as severely victimized by racism as other groups in this country. With this background we may now look at the black-white encounter in the delivery of medical care. Read more...
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