In his column, Calhoun listed several ways in which health outcomes are worse for black patients than for white patients, including that Black patients are three times more likely to die from pregnancy-related complications than white patients and that Black children are more likely to be physically subjected to emergency services than white children. Racist statements and attitudes contribute to and cause these disparities, Calhoun said.

“I think comments like making jokes about a black kid being in a gang definitely speaks to how they treat that black kid, if they’re diagnosed correctly, how they see that kid,” he said.

Dr. Marian Evans, an associate professor of public health at Southern Connecticut State University, said she has encountered racism as a doctor and as a patient.

“As a doctor, I’ve experienced, I’ve been aware of and I’ve been in the company of my other colleagues who are blatantly racist,” he said. “In dealing with the medical system with my family, I tend to make a concerted and intentional effort when dealing with the health care system not to initially tell them I’m a doctor because I think of the thousands of people who walk through these doors who don’t “No I have the benefit of the knowledge or skills to advocate that I do for my family. A lot of times I have to tell them, which changes the dynamic, and I shouldn’t have to.”

Addressing a concern

Evans is one of several local medical experts who said Calhoun’s proposal is an interesting and unique way to address a real concern in the medical field that has led to longstanding unequal care in the health care system.

“I think the real essence of Dr. Calhoun’s writing is that she’s trying to move people to do something,” Evans said. “She says there’s a problem with people’s behavior and that the problem with people’s behavior is because of the racism and systemic racism we have in our society. Body-worn cameras could be a way to document it.”

Evans said he believes there are critical differences between the role of police and the role of health care providers, and the literature on duration. The effectiveness of body cameras in reducing police misconduct is inconclusive.

“I think body cameras could be a tool, but if it’s the best use of the dollars, I’d say that remains to be seen,” he said. “We should go through a period like we’re going through with body-worn cameras with the police.”

Evans said there are also privacy concerns raised by the proposal.

“If you’ve been to the emergency room or had any type of surgery, you know that the health care system’s setup is not the best setup for privacy,” he said. “A curtain screen isn’t the best for privacy; you might not see them, but you can hear them talking.”

Calhoun said he believes HIPAA concerns could be addressed with a consent form.

“In my mind, patients would have the ability to decide if they wanted their medical team to wear body cameras,” he said.

He also said the images should be redacted before they are released to the public, just like police body camera footage. The advantage of having body camera footage, he said, would be largely for internal review if claims of misconduct or discrimination were made. The footage could also be used for training purposes to provide real examples of cultural competence.

Karl Minges, assistant professor and chair of the Department of Population Health and Leadership at the University of New Haven, is a health services researcher on health care disparities, including race and ethnicity.

“Studies have shown Black patients who are cared for by black doctors tend to do better, and that’s no shock. I think a lot of it comes down to cultural competency,” he said. “A lot of it comes down to understanding and treating people with respect and dignity, ultimately treating patients with person-centered care and seeing as people rather than a race or ethnicity.”

Minges said the body camera proposal is a “new approach to addressing a century-old problem.”

He said hospitals already have technology that takes patient privacy into account, so crafting a program that takes HIPAA into account isn’t out of the realm of possibility.

“As we see with police officers, it provides accountability and allows for awareness of one’s actions knowing there is a camera involved,” he said. “This boils down to the basics of why Target has cameras in their stores: It makes people aware.”

Minges said it’s normal for hospitals to have patient advocates, “but often [racist health care interactions are] under-reported, lack of evidence and lack of follow-up”.

“From a pilot stage it would be really interesting and intriguing to see the rollout. Maybe with accountability we would see black Americans suffer less medical violence and misdiagnosed care,” he said.

Dr. Lyuba Konopasek, senior associate dean of education at Quinnipiac University’s Frank H. Netter MD School of Medicine and a member of the American Association of Medical Colleges’ Anti-Racism Task Force, said the idea of equip health care providers with body cameras. it is laudable as “an immediate solution” to a major problem that has concerned medical professionals for a long time. However, he said he is concerned about the feasibility of adding a camera to conversations between health care providers and their patients.

“I think there’s something very personal about the doctor relationship that takes a lot to nurture. It’s very different from a street cop relationship and it comes with an incredible responsibility,” he said. “That’s the case with the police, too, but it’s a different kind of relationship. My sense is that a camera is stolen.”

Konopasek said a true test of cultural competence and improved outcomes in the medical field is the ability of health care providers to identify and mitigate their biases through regulation.

“For me, I would prefer to see a big effort to train our doctors in both implicit bias and recognizing their biases and how to mitigate them and communication skills,” he said. but how you communicate verbally and non-verbally’ is what’s important.

Calhoun said he doesn’t feel as though surveillance steals the doctor-patient relationship because of the long history of medical racism.

“I think the doctor-patient relationship, when it comes to black patients, has been broken from the beginning. I feel like, as a black patient, I’m under surveillance all the time in what I say,” he said. The problem actually lies in the relationship between medicine and the dehumanization that has happened to black patients, not a camera. I would feel more comfortable with a camera there as potential evidence.”

Evans said he believes an important distinction between police and health care providers is that, as government employees, police in most states have some degree of qualified immunity, which protects them from individual liability in the demands.

“It’s something that extends to law enforcement, but it doesn’t extend to health care professionals,” he said.

Evans said there is already a problem in the medical establishment of “practicing out of fear” of potential consequences.

“That’s a problem in and of itself — it’s a practice that already hurts doctor-patient relationships,” he said.

Minges agreed that the pressure on health care providers is already so high that videotaping is likely to do very little to ease that strain, making it unlikely that the proposal will receive popular support. medical establishment

“It opens the door to more trials,” he said. “Malpractice insurance is already very high.”

Calhoun said that while it provides more oversight of health care professionals, it could also be protective if providers can argue that the footage shows they responded to a situation appropriately.

As for whether the medical establishment is able to regulate itself and hold health professionals accountable, Calhoun said there would need to be conversations about the potential consequences before a body camera program is rolled out.

It is not the only tool

Calhoun said he doesn’t intend his idea to equip healthcare professionals with body cameras to be “the ultimate solution” to the problems that contribute to medical racism, but he does believe it could have a significant impact and make a positive difference. .

Other medical experts agreed that any solution to medical racism should be multi-pronged.

“Doctors and nurses aren’t necessarily all the sources of racism, because it’s a social problem,” Minges said. “That can be part of the solution, but it will have to be multi-level.”

Konopasek said bias “comes in all kinds of subtle forms” and “the hardest part” is that medical professionals have to be in constant dialogue about various solutions.

“This is not something that is solved in one way,” Evans said. “These systemic problems are not going to be solved in a day or a month or a couple of years. They are many, many layers of many, many different things.”

Evans said he believes an effective way to address disparities is to narrow the gap between the “two worlds of private insurance and Medicaid.”

“I think it’s going to take a little bit of everything. I don’t know anything to solve the problem,” he said.