Seeing Patients: Unconscious Bias in Health Care

Hardcover: 352 pages
ISBN 0674049055
978-0674049055
Harvard University Press
January 2011
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If you’re going to have a heart attack, an organ transplant, or a joint replacement, here’s the key to getting the very best medical care: be a white, straight, middle-class male. This book by a pioneering black surgeon takes on one of the few critically important topics that haven’t figured in the heated debate over health care reform — the largely hidden yet massive injustice of bias in medical treatment.

Growing up in Jim Crow–era Tennessee and training and teaching in overwhelmingly white medical institutions, Gus White witnessed firsthand how prejudice works in the world of medicine. And while race relations have changed dramatically, old ways of thinking die hard. In Seeing Patients White draws upon his experience in startlingly different worlds to make sense of the unconscious bias that riddles medical treatment, and to explore what it means for health care in a diverse twenty-first-century America.

White and co-author David Chanoff use extensive research and interviews with leading physicians to show how subconscious stereotyping influences doctor-patient interactions, diagnosis, and treatment.

Their book brings together insights from the worlds of social psychology, neuroscience, and clinical practice to define the issues clearly and, most importantly, to outline a concrete approach to fixing this fundamental inequity in the delivery of health care.

Augustus A. White III, M.D., is Professor of Medical Education and Orthopaedic Surgery at Harvard Medical School and the first African American department chief at Harvard’s teaching hospitals.

David Chanoff is a writer living in Marlborough, MA.

"As vital to medicine as mapping the rhythm of the heart and the firing of the nerves is an understanding of the diversity of the human family. Gus White takes us on a marvelous personal journey that illuminates what it means to care for people of all races, religions, and cultures. The story of this man becomes the aspiration of all those who seek to minister not only to the body but also to the soul." --Jerome Groopman, M.D., author of How Doctors Think

"Gus White has written a tour de force--a compelling story about race, health and conquering inequality in medical care. Growing up in the segregated South, receiving medical training at all-white Stanford, caring for Americans and Vietnamese in Vietnam, Dr. White has a uniquely perceptive lens with which to see and understand unconscious bias in health care. He offers astute analysis and prescriptions for eliminating inequalities, and his journey is so absorbing that you will not be able to put this book down." --Charles J. Ogletree, Jr., author of All Deliberate Speed

"Seeing Patients is a powerful and extraordinarily important book. Dr. White uses his own experience to enable us to take a close look at the sensitive issue of bias in health care, and the damage it does. He knows from the inside how good people can be negatively affected by historical and cultural forces they are not even aware of. He acknowledges the magnitude and complexity of the problem, and encourages medical schools and physicians to work together to solve it." --James P. Comer, M.D., author of Leave No Child Behind: Preparing Today's Youth for Tomorrow's World

"This is first and foremost the immensely enjoyable story of Gus White's astonishing life's journey. With all his achievements, he has not lost sight of his roots. Recruiting minorities into medicine has been one of his life's priorities, and he has been a leader in promoting cultural literacy in all physicians. Seeing Patients is both exciting and insightful." --Alvin F. Poussaint, M.D., Professor of Psychiatry Harvard Medical School

In this autobiography, White, Harvard's first African American department chief, writing with Chanoff, chronicles his experiences growing up in Tennessee and his professional journey through medical school. Along the way, readers are shown how racism has impacted and still affects African Americans and others in the medical profession and in the medical system in general.
--A. W. Klink (Library Journal )

Armed by the unique perspective afforded by being both within the American medical establishment and an African American whose grit and talent put him there, highly respected Harvard Medical School professor White is a crystal-clear visionary. The best means to improve health care for all, he says, is for medical schools to produce physicians who are not only scientifically competent but also equally culturally competent...Part stirring autobiography, part reasoned apology for egalitarian health care, White's book makes a powerful case.
--Donna Chavez (Booklist )

The intertwining journeys of both orthopaedics and civil and human rights are chronicled in Dr. White's life and career. Despite the progress made in these areas, unequal medical treatment in this country still exists due to biases, stereotypes, generalizations, language differences, and cultural barriers.
--Steven L. Frick, MD (AAOS Now )

"When White attended Stanford in the late '50s he was one of four students of color. A recommendation letter written by a mentor then included "this is a pale, colored boy" to avoid misunderstanding. Now White recounts his ground-breaking life in an engaging, matter-of-fact manner. Eight of the 12 chapters tell his amazing story, from his birth in 1936 in a segregated Memphis (his trailblazing father, a doctor, died when White was only eight), to a 1967 tour of Vietnam wherein White worked in a leprosarium, to a fellowship at a biomechanics lab in Sweden, to his appointment to head a new orthopedic academic program at Harvard. A chance encounter with a woman who felt doctors judged her by her full-body tattoo led White to consider disparities in health care. Challenges exist on both sides of the stethoscope, White argues, noting that the uncertainty felt by many African-American patients over how they will be perceived also impacts the medical encounter; the burden for alleviating racial and other disparities (such as those based in age, gender, and sexual orientation) falls on the medical and educational communities. Accessible, thought-provoking, and valuable." - Publishers Weekly

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