A new study in the January issue of the Journal of Pain and Symptom Management indicates that doctors may have less-compassionate nonverbal interaction with terminal Black patients than with White ones.
The study, titled "Differences in Physicians’ Verbal and Nonverbal Communication With Black and White Patients at the End of Life," was conducted by researchers at the University of Pittsburgh School of Medicine and Purdue University’s College of Health and Human Sciences. The researchers sourced 33 doctors at hospitals around Western Pennsylvania, having them complete two recorded interactions with actors portraying terminally-ill patients (one was Black, the other was White). The "patients," accompanied by actors playing a family member, read from identical scripts concerning end-of-life care. While doctors knew they were being studied, they did not know about the purpose of the study until later.
The researchers found that although the doctors showed no difference in verbal communication between patients, there were "fewer positive, rapport-building nonverbal cues when speaking with black patients." Doctors speaking to Black patients were more likely to stand towards the door while "with the white patients, the physicians were more likely to stand right at the patient’s bedside and touch them in a sympathetic manner," said senior author Dr. Amber Barnato in an additional statement.
Findings in this study have further implications for understanding how racial bias affects doctors treating patients of different races, as well as patients’ decisions on their care. Dr. Barnato explained some of these implications in the aforementioned statement:
"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,” said Dr. Barnato. “However, blacks are much more likely than whites to request such care when they are faced with making the decision in the hospital. 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. To help black patients and their families feel welcome and encouraged to be partners in medical decision-making, it is critical that doctors be aware of their verbal and nonverbal communication and any unintentional biases.”