Medical Racism and the Rhetoric of Exculpation: How Do Physicians Think about Race?

Over the course of the past two decades, the medical literature has published many peer-reviewed studies pointing to racially differential diagnosis and treatment by American physicians. These publications eventually produced an official report by the Institute of Medicine of the National Academies (Unequal Treatment, 2003) that confirmed the existence of widespread racial health disparities. Yet the detection and prevention of racially motivated misconduct by physicians has never made it onto the agenda of American medicine. The medical publications that do raise questions about differential (and potentially harmful) diagnosis and treatment, while essential to understanding the racial dimension of medicine, focus primarily on relieving medical practitioners of any responsibility for their racially motivated behaviors. Medical authors have developed a rhetoric and a euphemistic vocabulary that aim at preserving the humane reputation of the medical profession. This evasive strategy is reinforced by physicians' ignorance of the history of medical racism in the United States. Improved race relations within American medicine will come about when the medical profession confronts its own legacy of medical racism and requires physicians to learn something about how doctors think about race.