By Austin Newell
NASHVILLE, TN — About two weeks ago, AAPA, an organization made up of thousands of Physician Associates (PAs), held a national conference at the Music City Center in Nashville. One of the talks given was on the subject of eliminating race-based practices in clinical medicine, headed up by PAs Kara L Caruthers, Susan LeLacheur, and Howard Straker.
The three, who gave a presentation on the same topic last year and received a standing ovation, charge that many systems and lines of thinking within the medical community are racially biased. From the way a doctor looks at your lungs, to how a finger pulse oximeter gets its readings, which measures oxygen levels.
“If you have the type of melanin that’s expressed in my skin, it’s actually harder for you to pick up my oxygen level. Because the way that instrument was created was for people with lighter and white skin.” Said Caruthers. “And so that then means if I actually had COVID or if I had a respiratory illness and something was going on and you said ‘Oh well Kara’s oxygen saturation level is 98% she’s fine.’ but it’s a faulty tool that we use, well now my oxygen saturation percentage really might be 92%, and you might need to put some oxygen on me, or instead admit me to the ICU.”
To make things clear: Carut LeLachuer and Straker are not saying that all doctors today are being purposefully malicious. It’s simply what many have been taught their whole lives.
“We were trained to use these things, and we were following them as medical clinicians.” Said Straker.
According to them, It’s all carried over from outdated and racially biased medical teachings, some going as far back as hundreds of years ago.
“With some of the lung stuff, you can trace that back at least to Thomas Jefferson. Who owned people including his own family, but most of those people were subjected to some pretty bad conditions and crowding and poverty, and he noted that their lung function was not as good. Well, if you put me in a field of tobacco i’m not sure mine would be very good either.” Said Lelacheur.
Caruthers says that this investigation was all spurred on by the COVID-19 pandemic, and seeing how it disproportionately affected people of color.
“The pandemic had us giving undivided attention to information and to various things, and with the pandemic we also saw that there was disparities as to who was impacted. Who was dying more frequently? Who was able to work from home and work remotely versus those who had to go in and be present and work in service industries etc.” “And we started to see there are some differences in socioeconomic status and certain socialized racial groups in who COVID’s impacting.”
“It goes on and on, there are guidelines on pediatric UTI, there are guidelines on who gets what kind of care in the hospital. It’s woven throughout systems of care in ways that are really difficult to unravel. And this is not to say that there are not differences, but the cause of the differences is not genetic, because race is not genetic.” Said LeLacheur.
If the reception to Caruthers, LeLacheur, and Straker’s work is anything to go by, the medical community is incredibly receptive to their ideas. If more work is done to change things, it could have the potential to save countless lives in the coming years. Straker hopes that by teaching people in the profession about this issue, things will change for the better.
“That’s one of the reasons we’re all teachers, we’re all faculty members, specifically to influence the future generations as much as the current generation of folks who are taking care of people.”
