In the sprawling ecosystem of military health care, a recent study has underscored a troubling pattern: the interplay of rank and race significantly sways the quality of treatment military personnel receive in emergency rooms. The meticulous study, published in the journal Science, examined a staggering 1.5 million ER visits within the military health system, unmasking a hierarchical skew in patient care that mirrors societal biases.
The research team from the University of Texas at San Antonio and Carnegie Mellon University provided stark data: higher-ranking individuals – those who outranked the attending physician – benefited from 3.6% more medical effort and resources and faced 15% lower odds of poor outcomes. Simultaneously, lower-ranking patients experienced deteriorated care when doctors were treating higher-ranking individuals concurrently.
Stephen Schwab, a study co-author, highlighted that white physicians showed less effort in treating Black patients, irrespective of rank. Schwab, a retired Army lieutenant colonel, emphasized that the military is striving to attenuate these biases by understanding the scope of the problem, which spans beyond race and gender to include power dynamics. The nuanced findings revealed that while Black military doctors treated lower-ranking patients of any race relatively equally, the same could not be said of their white counterparts. In contrast, Black physicians provided exemplary care to high-ranking Black patients, showcasing “off-the-charts” effort.
Peter Graves, a spokesperson for the Defense Health Agency (DHA), responded to the study with a commitment to delivering the highest quality of care to all patients, “regardless of rank, race, color, sex, gender identity, religion, age, or any other demographic.” This aligns with the military’s health system’s ethos of providing equitable care, a sentiment echoed in Schwab’s comments.
The study’s implications reach beyond the confines of military institutions, suggesting parallels in the civilian healthcare sector. It pointed out the existence of ‘VIP patients’ and ‘red-carpet’ care within civilian settings, insinuating that power dynamics prevalent in military settings might be reflective of broader societal issues. This raises crucial questions about systemic injustices and disparities in care and treatment that might pervade various professional environments, whether in uniform or not.
The study also found that male physicians were more rank-conscious than female physicians and exhibited more gender-based discrimination. Interestingly, male doctors were notably more responsive to higher-ranking female patients, possibly due to the rarity of such high ranks among women within the services, potentially eliciting more respect and attentiveness.
Relevant articles:
– Officers with Higher Rank Get Better Care than Those with Lower Ranks at Military Hospitals, Study Finds, Military.com
– In military medicine, study shows rank and race affect care, statnews.com
– 9 Military Hospitals Receive Top Marks for Patient Safety, Military.com
– The Pervasive Role of Rank in the Health of U.S. Veterans, National Institutes of Health (NIH) (.gov)