Tackling the Biases That Undermine our Health Care
April 17, 2023
This uneven debut by physician Marshall explores discrimination in the American health care system. Marshall draws on social science research and stories from her practice to survey how race, gender, sexual orientation, weight, and age affect the medical care patients receive. Examining the impact of racism, she tells the story of a white cardiologist who dismissed the suffering of a Black woman referred by Marshall and discusses a 2019 study that found white participants “more readily recognized pain on White faces than on Black faces.” The author explores how ableism and ageism affect care, noting that a third of adults with a disability “have unmet health-care needs because of cost and transportation challenges,” and that older individuals are often infantilized by doctors who “assume senior patients are mentally impaired.” The anecdotes drive home the everyday failures of the medical system. However, though Marshall purports to write “for both health-care practitioners and patients,” she addresses her advice largely to the former (she recommends adding cultural competency training and a required geriatrics rotation to medical school curricula), offering little for patients on how to find better doctors and advocate for themselves. Though this struggles to balance its numerous objectives, it makes for a competent survey of how the American medical system lets down vulnerable communities.