Title : Improving patient-provider relationships through a historic analysis of medical divergence from the normative body
Abstract:
Medical mistrust in the patient-provider relationship is based in a history of discrimination and abuse of minority groups across race, gender, and socioeconomic status as they diverge from the standard of the normative body. By analyzing this divergence through a historical lens, medical providers begin to parse their implicit biases, historical biases of medical information, and the ways in which this affects their patient interactions. This review will provide communication techniques to address medical mistrust from the provider perspective and patient perspective to improve the patient-provider relationship. This project aims to define the socionormative body, the history of medical abuse in minority populations, and the resulting continuance of medical mistrust. Examples of medical abuses in BIPOC, impoverished, LGBTQ+, and other vulnerable populations will be discussed. This in turn will be analyzed as a source of medical mistrust in the current US healthcare system. Ultimately, I ask providers to reflect on their own biases using the framework of Transformative Learning Theory (TLT) in concert with implicit bias management techniques, as confirmed by Sherman et al. in creating more sustained awareness of implicit bias and commitment to addressing it at 4 months post-education. This framework proposes disruption of assumptions followed by critical reflection of those disruptions and the providers’ reactions to it. Limitations of this framework include sustained improvements in the long term due to discrete educational time frames and return to systems that support providers’ implicit biases. Other frameworks include word-association testing as used in the Implicit Association Test (IAT), which has limitations in testing-retesting of changes on an individual level and use in predicting clinical behavior, and Medical Student Cognitive Habits and Growth Evaluation Study, which was dependent upon long-term positive student-patient interaction with minority populations and susceptible to variability in medical school faculty. Finally, I will discuss communication styles and behaviors that address perceived mistreatment of minorities in medical settings. Providers can utilize this review as an easily accessible resource for their patient interviews in clinical settings to see an improvement in provider-patient relationships.
