He aims to humanize health care
Dr. Omar Sultan Haque
Haque, a psychology PhD candidate at Harvard, wrote a piece with Adam Waytz in the current issue of Perspectives on Psychological Science about the dehumanization of medicine.
Q. What do you mean when you say that medicine has been dehumanized?
A. Dehumanization means denying a distinctively human mind to another person. It refers to any situation in which you have diminished appreciation for other people’s mental states. In the medical context it primarily means treating patients like objects - more like pets than people. Labeling people as their diseases. Bad bedside manner. Exacerbating disparities in care based on group differences. You see it everywhere when you look for it.
Q. You got interested in this subject while in medical school, watching yourself become dehumanized?
A. The thing that got us interested was this irony: Empathy decreases as you get more experience with patients. The nicest people you’ll ever find who are doctors are in the first two years of medical school.
Q. Brain science indicates there’s a tradeoff between empathy and problem-solving?
A. Those things seem to be hard to do at the same time.
Q. Wouldn’t it sometimes be useful in medicine to focus on problem-solving instead of empathy?
A. When you treat people as if they’re made up of interacting parts, that tends to help with diagnosis and treatment. But then in a study of radiologists, where they put a face on a radiological image - you would expect that if this dehumanization were functional they would get worse at their jobs, because now they have to think about people instead of “is it the gall bladder or small intestine?’’ But they had more accurate diagnoses, wrote longer reports, reported more details. Even there, [humanizing the patient] seems to improve the ability of doctors to work and do their jobs.
Q. What’s your antidote for this dehumanization?
A. The most radical thing we suggest is getting rid of the white coat [that doctors wear]. It seems like one of the most obvious examples of a holdover of a hierarchical, institutional practice - these traditions that prevent medicine from being as humane as it could become. The physicians’ garb is lofty, clean, pristine, and the patients’ are humiliating, degrading.
Q. What can people going into a medical situation do to protect themselves against being dehumanized?
A. As a patient, they can try and wear personalizing garb as much as possible. They can ask to bring in their own scrubs; they can ask doctors to look them in the eye when they talk to them. They can recognize that they should be actively involved in their decision-making. Maybe bring pictures of their family with them to the hospital - anything that reorients them to remaining a human being. They should look to undo power asymmetries by asking personal questions of their physicians: “Have you ever had surgery, doctor?’’ Anything you can do to help yourself remain humane to others and be treated humanely will help.
Q. Does your work have implications for disparities of care, explaining why members of minority groups often have worse health outcomes?
A. Out-groups are already lower in how much we distinguish them as individuals. You put an out-group in a hospital gown, you’re basically multiplying that effect, you’re dehumanizing the already dehumanized. That might explain some racial disparities, less individualized care. Unless you’re a white male who’s fit and straight and not too old, not too poor, not too sick, your chances are increased of getting less than ideal, and often unfair, care.