Diminishing bias in sickle cell disease

Dear Sir

Increasing the use of reflection as well as an educational focus on the humanistic approach to care holds great hope for diminishing provider bias in caring for individuals with sickle cell disease (SCD). It is an inherited red blood cell disorder affecting approximately 100,000 individuals in the United States, mostly African Americans. Individuals with SCD often face bias from providers who believe they are exaggerating their pain complaints to obtain pain medication. This bias frequently creates an antagonistic relationship between patients and providers. Reflection is frequently taught in medical school and often involves writing or debriefing after a live patient encounter. For example, after working in the Sickle Cell Infusion Center (SCIC), a medical student reflected that in his future practice he would adopt the SCIC's policy towards pain management, which is that, regardless of a patient's capacity to be “drug-seeking” their pain should still be quickly and adequately treated. We offer an alternative model. A brief video-intervention, showcasing patients in crisis, as well as discussing treatment received from providers when seeking care for a painful crisis, created by researchers at Johns Hopkins University improved provider attitudes towards individuals with SCD (Haywood et al. 2010). Reflection after viewing such a video can allow medical students to gain better understanding and empathy for individuals with SCD.

It is important for providers to know how to provide compassionate care. Reflection can assist in creating empathetic and caring providers. It should be emphasized that it is a clinically relevant skill which can aid students in their personal growth throughout the course of their career (Song & Stewart 2012). By creating this new generation of providers with a more humanitarian approach to the care for SCD, individuals living with the disease will receive the unbiased compassionate care everyone in pain should receive.