Pain Discrimination

A recent article in TheNew York Times took me by surprise the other day: "Minorities Get Less Pain Treatment in E.R." Although, sadly, maybe I shouldn't be that surprised by it? But I am, because part of me just doesn't want to believe and know that so many people are continually discriminated against and, well, screwed over in our mess of a healthcare system.

According to the article, white patients receive more pain treatment in the E.R. than African-Americans and other minorities--according to a new report from a study conducted by the Centers for Disease Control and Prevention. The article goes on to report that patients were also less likely to receive pain medication if they were over 75 or male, lacked private insurance or were treated at a hospital with numerous minority patients.

Why is this? Why should it matter what race, age, or ethnicity you are in order to receive good and equal treatment for pain? As far as I'm concerned, it shouldn't matter, yet it continues to happen. Pain is pain, no matter who you are; it does not discriminate.

The senior author of the study, Dr. Adil H. Haider, states in the article: “It may be that different people communicate differently with their providers. If we as providers could improve our ability to better communicate with patients so that we could provide more patient-centered care, we’ll be making several steps toward reducing and hopefully eliminating these disparities.”

Unfortunately the article is very brief and doesn't go into further detail or analysis about the possible causes of these types of discrimination in the E.R. What sort of communication challenges or barriers are the non-white patients having with their providers? Is it a language barrier? Attitude to treatment? Miscommunication about symptoms and/or a hesitancy to reveal personal information? This is basically the first I've heard about the issue, so I'm mostly grasping at my own ideas and scenarios right now, wanting to understand.

It's also troubling to find that according to the study, there's a trend of senior citizen patients not receiving adequate pain medication, as well as males and patients who don't have private insurance. What do you think the reasons for this could be? Whatever the reasons and causes, I agree with Dr. Haider that there needs to be more patient-centered care in the E.R., the rest of the hospital, and everywhere, really.

I firmly believe that patients and doctors need to work and communicate together, as a team, in order to provide the patient with the best care possible. There is still way too much miscommunication and misunderstanding (and apathy) going on between doctors and patients. The patient needs to feel comfortable and be able to communicate his or her health needs, and the doctor needs to genuinely listen to the patient and work with him or her towards the best possible outcome.

As a young, white female, I often feel unfairly judged and stigmatized myself when it comes to needing and asking for pain medications. I can't imagine how much more difficult it must be for minorities to feel that they have a trusted relationship with their doctors and that their needs are heard.

Nobody should have to suffer from pain, and it shouldn't matter what your culture, gender, age, or the color of your skin is if you're going to the E.R. just to get some help.