Stereotyping in medical settings – ouch
04/18/2013 12:00 AM
04/17/2013 1:36 PM
'Could you help me get the cirrhotic liver in bed 403B down for his CT scan?"
"I need to go order medications for the AIDS patient in room 5320."
"She's an epileptic, so she needs to have padding placed on her bed rails."
"You know what the sheik admitted yesterday morning? Well, he needs some additional blood tests."
Hearing comments such as these is not uncommon in hospitals across the nation. The people who speak them are probably not biased, nor are they bad people. They are selecting these quick descriptors as short cuts in language to quickly convey a message to a co-worker. But to many of those people being assigned these labels, the descriptors are stigmatizing and even offensive.
Such comments are perceived as taking away a person's individual identity. The labels can even have adverse consequences.
The person with AIDS in bed 5320 has a first and last name, a family and a rich life outside of dealing with AIDS.
The same is true for every other patient we encounter.
Why do we reduce people to a label? Perhaps because we are lazy and perhaps because we haven't taken the time to get to know the person with AIDS so they can become more than just a disease label.
No doubt some readers are rolling their eyes and feeling that this is all just political correctness.
It is not.
Not when behaviors and attitudes are consistent with the language we use.
In one study, 200 healthy high school students were asked several questions about those with epilepsy. For half the students, the questions referred to a "person with epilepsy."
The other 100 students received the identical questions but the reference was to an "epileptic." When asked about a "person with epilepsy," students were far less likely to feel the person would be rejected by society, have trouble finding a job or be stigmatized at school than those who answered the same questions about an "epileptic."
Students were also less likely to admit prejudice toward a classmate when the classmate was called a "person with epilepsy" than when called an "epileptic."
So when you ask the same group of high school students the same questions and just change the label, attitudes shift.
I suspect that if we surveyed people with epilepsy, AIDS, liver disease or members of any religious group, all would agree that they find such stereotyping labels uncomfortable in a medical setting and that they might worry that the health care professional using such labels held negative attitudes about them.
Personally, I can't recall hearing any health professionals ever refer to positive stereotypes to describe people – the "exerciser," "the person with outstanding blood pressure" or "the person with very low cholesterol" in room 5332.
Labels most can lead to patients becoming objects and not the people behind the label. It is a dangerous route for health professionals to lose sight of the human experience.
The interpersonal relationship can be lost, the patient can feel disregarded, and attempts to truly connect and heal will be lost.
Michael Wilkes, M.D., is a professor of medicine at the University of California, Davis. Identifying characteristics of patients mentioned in his column are changed to protect their confidentiality. Reach him at email@example.com.
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