Within medicine there has been a renewed focus on a holistic, patient-centered approach to patient care, rather than solely focusing on clinical markers of health and disease. Factors such as experiences of discrimination, racism, and mistrust in health care occur within the medical setting and may affect a patient's quality of life.
To examine these factors, Michael Freeman, MD (University of Pittsburgh) and his colleagues followed 590 kidney failure patients as they proceeded through the kidney transplant evaluation process. Patients completed two interviews: one at the time of initial transplant evaluation, and another when the transplant evaluation was completed. Perceived racism, experiences of race-based discrimination, medical mistrust, and trust in physicians were assessed at the first interview. Quality of life was assessed at the second interview.
Patients who said they had more experiences of discrimination in health care, greater medical mistrust, and lower trust in one's physician at the first interview had poorer quality of life by the second interview. Greater perceived racism in health care predicted poorer quality of life regarding patients' symptoms, effects on daily life, work status, and cognitive function.
"These data indicate the injurious effect that discrimination and mistrust in health care may have on our patients, and indicate areas for patient-, provider-, and system-level focused interventions," the investigators wrote.