Patient’s Medical History: Should the Description of Race and Ethnicity be Forbidden?
There is concern that I and others who teach medical students to take a medical history and perform a physical examination have been teaching the wrong way. We have always been teaching the student to start off the history with, as an example, “The patient is a 35 year old Hispanic married male carpenter who…”
We are now told by those who know: writing Hispanic may be discriminatory and also used as a stereotype (and the same goes for black, African-American, Asian and so on). Not only that but these days the word "married" is inconsequential in terms of making a diagnosis. How about the word “carpenter”? It might be used as a stereotype and be discriminatory. How about age? Can be used to discriminate and stereotype? "Male" or "female"--too biological not humanistic--"man" and "woman" is better.
The argument against writing the race or ethnicity as identifying elements is that also these days most physicians may not know “who is what”? And the argument is there is such a mixture of race, cultural backgrounds or religions that simply the appearance of the patient may not be definitive. If the patient is asked specifically about what race they represent in order to identify a related disease (and most doctors rarely if ever directly ask such a question), the patient’s response may not be clinically relevant if one realizes the genetic complexity of every named race.
So this is the issue: should our teaching be changed and the example introductory line for a medical history begin “The patient is an adult man who..” ?
To read more about this issue:
"Misuse of Race in Medical Diagnosis" by Richard S. Garcia in “The Chronicle of Higher Education".
University of California San Francisco Medical School Statement regarding the Use of Race and Ethnic Identifiers 2006.
Write us here what is your opinion of the writing of race and ethnicity as identification of a patient in the patient’s own medical record. ..Maurice.