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Not all patients who present to the emergency room would be equal. Depending on their gender and ethnic origin, the seriousness of their situation will not be appreciated in the same way. The results of the study conducted at Montpellier University Hospital reveal discrimination in care.
It would be better to be a white man than a black woman to be taken seriously and therefore properly treated in the emergency room. The explosive results of this study conducted at the Montpellier University Hospital point to unconscious bias during patient triage, the assessment of the severity of symptoms which will lead to more or less rapid treatment.
Same symptoms but different patients
The study was carried out among 1,563 caregivers, spread across four countries: France, Switzerland, Belgium and Monaco. Among them, there were 50% emergency physicians, 11% emergency medicine interns and 39% emergency nurses.
The caregivers were subjected to clinical cases of patients presenting the same symptoms but different in terms of gender or ethnicity: 4 men and 4 women, in medium shot, hand on chest, dressed in the same colors but from different ethnic groups: Asians, whites, North Africans and blacks.
“The caregivers had to give the level of seriousness (prioritization) of this clinical case. It was always the same, but the person presented different characteristics, in terms of gender and ethnic appearance. This patient image was constructed by a software for constructing realistic virtual photos based on AI -Artificial Intelligence- and represented a character standing with his hand on his chest, simulating pain. explains the Montpellier University Hospital.
Women and black people less well taken care of
Results: the clinical case was considered a life-threatening emergency in 62% of cases when it was a man compared to only 49% of cases when it was a woman.
Also, in 58% of cases, the clinical case was judged to be a life-threatening emergency when it was associated with a white person compared to 47% when it was a black person. Finally, in 63% of cases, the vital emergency was estimated for a white man, compared to only 42% of cases when it was a black woman.
“This trend was first noticed in the early management of heart attack. Numerous scientific articles, particularly from North America, show differences in care linked to the sex and ethnic origin of patients. However, it had not yet been established whether these differences were linked to less intensive treatment or to a less severe assessment of severity. further notes the CHU in its press release.
Raise awareness and improve care
The results of this study show that even today, the assessment of the severity of a patient’s state of health is subject to discrimination. “This medical, sexist and racist reflection is based on experience, experience, feelings and also convictions” recognizes Professor Xavier Bobbia, who led the study. “The evidence shows that female doctors are just as discriminating as male doctors in assessing the severity of a woman’s symptoms. he believes.
What are the solutions to this observation? According to him, we need to talk about it and recognize the “unconscious assumptions” that exist. The second point is to make “more objective assessment at emergency reception thanks to the implementation of triage scales which are recommended by the French Society of Emergency Medicine“. And finally, he counts on “the development of artificial intelligence” which will perhaps allow “predict severity“of the state of health of a patient”less tainted by our cultural problems” he concludes at the microphone of France Info.
Results which only half surprise Dr. Gérald Kierzek, emergency physician and medical director of Doctissimo. “The assessment of severity is based on questioning and on sometimes subjective and cultural criteria. The differences between men and women in the management of acute coronary syndrome have, for example, already been objectified and numerous American studies have also shown ethnic disparities. However, we cannot speak of discrimination and the objective is to minimize or even erase prejudices (on age, background, etc.) by triage scales at the entrance to the emergency room; they are based on objective criteria and are mandatory and applied everywhere in France.”