Medical Professionals and the “Heal Thyselves” Hope
It appears that fatphobia among medical professionals has been disappointingly and rather shockingly widespread, and may still be. A few years back, a research team looked into the terminology most resisted by patients, but also pointed out how difficult it is for medics to please everybody in such a sensitive realm.
The document in question is an exploration of issues and observed behavior that had been looked at before, and have continued to be scrutinized in the recent past, and will probably need an eye kept on them in the future. In “Implicit and Explicit Weight Bias in a National Sample of 4,732 Medical Students,” the authors state,
Although the medical profession attracts people who are highly committed to helping others, those pursuing the profession are still susceptible to societal biases against obese people… Implicit and explicit weight bias is common among 1st year medical students, and varies across student factors.
Also drawing from other previously published materials, the team set out to explore “the magnitude of explicit and implicit weight biases compared to biases against other groups.” First-year students from 49 medical schools participated in a survey designed to get a handle on exactly how much anti-fat sentiment existed among them. For agreement or disagreement, it offered the participants such statements as:
I really don’t like fat people much.
I have a hard time taking fat people seriously.
Fat people tend to be fat pretty much through their own fault.
Some people are fat because they have no will power.
Among many of the respondents, attitudes tended to be judgmental, but a considerable self-referential emotional component was also at work. Apparently the very existence, and especially the close proximity, of overweight humans can trigger existential angst:
Fat people make me feel somewhat uncomfortable.
I feel disgusted with myself when I gain weight.
I worry about myself when I gain weight.
As it turned out,
A majority of students exhibited implicit (74%) and explicit (67%) weight bias. Implicit weight bias scores were comparable to reported bias against racial minorities. Explicit attitudes were more negative toward obese people than toward racial minorities, gays, lesbians, and poor people.
That statement should stop any thinking person in their tracks.
In addition to the study this work is mainly concerned with, the authors cite many previous research papers that also apply to the dilemma. They note the existence of a “growing body of research” that reveals care providers’ “explicit and implicit biases about patients’ stigmatized social characteristics.” Obviously, such attitudes can endanger aspects of patient care, and possibly decrease the likelihood of deriving any benefit from interaction with the medical establishment. The authors say,
It has been observed that race bias in healthcare providers follows a pattern of high implicit bias and low explicit bias, which has been labeled aversive prejudice.
Explicit biases are defined as being intentional and conscious, and are assessed by self-report, in a process where it is hoped that honest responses can be assumed. The majority of the research intention was to capture and focus on the implicit sort of bias, the sort that is automatically activated within the subject’s psyche and occurs unconsciously, although it is to be hoped that participants can eventually recognize it in themselves. This sort of reaction is measured using response-latency tasks like the Implicit Association
Task (IAT), which measures “the strength of association between social categories and attitudes.”
In the medical context, common stereotypes involved in a care provider’s implicit or explicit racial bias have been linked to less-than-optimal behavior in the areas of decision-making; the judgment of communication as satisfactory or otherwise; and of course in the ratings requested from patients about the quality of care. Since some students honestly reported that they liked obese people even less than racial minorities, this did not bode well.
Medical personnel are of course often called upon to treat not only members of other races, but convicted criminals who, while they should be entitled to humane care, probably do not deserve large amounts of approval. Physicians, nurses, and other staff are also compelled to deal with patients in extreme states of disorientation or hostility caused by alcohol or illicit drug use, involving substances whose effect sometimes turns out to be more homicidal than recreational. Medical personnel have to confront the sometimes grotesque results of sexually transmitted diseases and other conditions with which the ordinary citizen is thankfully unfamiliar.
And yet, somehow, for some individuals, taking care of overweight patients can be even worse.
(To be continued…)
Your responses and feedback are welcome!
Source: “Implicit and Explicit Weight Bias in a National Sample of 4,732 Medical Students: The Medical Student CHANGES Study,” ResearchGate.net, April 2014
Image by CaringforCare/Pixabay
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