Half of dermatologists aren't trained to spot cancer on black skin

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http://nymag.com/scienceofus/2016/0...black-skin.html?mid=twitter-share-scienceofus

Although black Americans with melanoma, a type of skin cancer, are more than four times as likely as white Americans to be diagnosed only after their cancer has already spread to other parts of the body, half of dermatologists report that their medical schools did not prepare them to diagnose cancer on black skin.

And barely 1 in 10 dermatology residencies include a rotation in which physicians-in-training gain specific experience treating patients with skin of color.
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That figure – that half of dermatologists say they were not trained to spot signs of cancer on black skin – comes from research presented at a 2011 meeting of the Society for Investigative Dermatology. As far as I can tell, it was never published in a medical journal – and, that, too, is part of the problem here. As one review of the literature, published in 2012 in the journal Dermatologic Clinics, notes, “there remains a scarcity of robust basic dermatologic research examining skin of color.”
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Also:
Half of physicians in one survey, for example, believed at least one untrue statement implying “biological differences in pain perception between blacks and whites,” which no doubt leads directly to this next depressing stat: ER doctors are up to 30 percent less likely to give pain medication to black patients than white patients, even when the subjective level of pain reported is the same.
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Shocking lol and niggas thought I was crazy when I said you should try and get a black doctor whenever possible. I know firsthand that these non black doctors think crazy shot about us.
 
bunk-the-wire.gif
 
Just because they specifically didn't learn something in school does not mean they aren't trained to do something. Topic title is misleading.
 
Euphor!a said:
Just because they specifically didn't learn something in school does not mean they aren't trained to do something. Topic title is misleading.
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Half of physicians in one survey, for example, believed at least one untrue statement implying “biological differences in pain perception between blacks and whites,” which no doubt leads directly to this next depressing stat: ER doctors are up to 30 percent less likely to give pain medication to black patients than white patients, even when the subjective level of pain reported is the same.
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sooooooo what about this part?
 
Euphor!a said:
Just because they specifically didn't learn something in school does not mean they aren't trained to do something. Topic title is misleading.
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It's not a statistic that's easily brushed off.

If they have more experience with cancer on white skin, it means they have a better chance at detecting it in contrast to black skin, even if they learn techniques later on (which I'm doubtful of that the study did not take into account).

Doctors are not infallible, they won't always pick up on things, but I'd much rather have less of a chance by making it mandatory teaching in school rather than leaving it up to "training elsewhere".


Also daily notice to wear sunscreen whenever exposed in the sun each day to save yourself from 80% of wrinkles in the future.
 
My Pops went to a dermatologist for a checkup and had a spot on his skin that worried him. Doctor told him not to worry. He went to a second dermatologist anyways and the doc told him it was cancer. Cut it out and keeps an eye on it.

Trust your gut, question your doc.
 
Difficult to see moles on black skin and compunded by the fact that due to melanin, skin cancer is quite uncommon among blacks, it's reasonable to expect that doctors neither don't have the experience nor the training. Does this make it more acceptable? No I expect to be able to go to a doctor with a problem and have it accurately treated for no matter the color of my skin.

While this may not be a product of malicious intent it does speak for the fact that blacks may have been an afterthought and no matter the reason on why that is, people should be expected to get good medical care.
 
Euphor!a said:
Just because they specifically didn't learn something in school does not mean they aren't trained to do something. Topic title is misleading.
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Residency is where you are trained in dermatology. If you don't learn it there you are out in the field practicing on real patients.
 
Africanus said:
It's not a statistic that's easily brushed off.

If they have more experience with cancer on white skin, it means they have a better chance at detecting it in contrast to black skin, even if they learn techniques later on (which I'm doubtful of that the study did not take into account).

Doctors are not infallible, they won't always pick up on things, but I'd much rather have less of a chance by making it mandatory teaching in school rather than leaving it up to "training elsewhere".


Also daily notice to wear sunscreen whenever exposed in the sun each day to save yourself from 80% of wrinkles in the future.
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I'm certainly not brushing it off and schools should certainly cover diagnosing skin cancer on black skin specifically as it is likely not as easy. Just saying that not learning something in school is not identical to not being trained to do something.
 
EdibleKnife said:
People should read Medical Apartheid. Lots of medical experimentation was done on black people under the idea that since we were closer to livestock, our pain tolerance was higher compared to white people.
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This is crazy. It just seems so strange to me that a white person could look at a black person back then and think they were so much different than them. It doesn't even make sense from a reasonable perspective.
 
Krappadizzle said:
This is crazy. It just seems so strange to me that a white person could look at a black person back then and think they were so much different than them. It doesn't even make sense from a reasonable perspective.
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There were a lot of hoops people jumped through for the sake of racial superiority. The lack of empathy required would and was deeply damaging.
 
I don't see how susceptibility factors in here.

If you're seeing a dermatologist there is already a current skin issue that either you or your primary doctor has a concern about. Dermatologists are dropping the ball when they see patients with concerns.

http://www.ncbi.nlm.nih.gov/pubmed/14699360
A total of 649 African American and white patients were treated for melanoma at the Washington Hospital Center between 1981 and 2000. Of these, 36 (6.1%) patients were African American. African American patients were more likely to initially be seen with stage III/IV disease (32.1%) compared with (12.7%) the white patients initially seen with these disease stages. Of the white patients 60.4% were initially seen with melanoma in situ/stage I disease compared with 39.3% of the African American patients. The 5-year survival rate was 58.8% in African Americans compared with 84.8% in whites.
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Black: 15 of 36 died
White: 92 of 613 died
 
The Lamp said:
Residency is where you are trained in dermatology. If you don't learn it there you are out in the field practicing on real patients.
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I think he means that they are trained to spot melanoma on people. Just because they weren't specifically trained to spot melanoma on black people doesn't mean that they can't actually do it.
 
Joe said:
I don't see how susceptibility factors in here.

If you're seeing a dermatologist there is already a current skin issue that either you or your primary doctor has a concern about. Dermatologists are dropping the ball when they see patients with concerns.

http://www.ncbi.nlm.nih.gov/pubmed/14699360

Black: 15 of 36 died
White: 92 of 613 died
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I would imagine that most melanoma concerns are self reported, who here even gets an annual dermatologist check-up. I would imagine white people are more likely to be looking for and spot something abnormal at the early stage.
 
Not for nothing, but it's not just a training thing. Dark skin makes medical visual inspection harder, in general, simply by virtue of the lack of contrast. Sticking an IV on a darker-skinned person is often more difficult, as well, because their veins don't contrast as sharply against their skin, and you have to rely more on subtler markers (bulging of skin, palpation of the vein). Combine that with the fact that many dermatologists probably practice in areas where dark-skinned clientele make up a small portion of their total patient load (practice/experience is everything in medicine), and, yes, a relative lack of training, and yeah, you have a recipe for lower quality of practice. Thankfully, in this instance, black folk are insulated by having comparatively WAY lower rates of skin cancer, thanks to their many melanocytes.
 
This is a bit sensationalist. It's simply harder to diagnose melanoma in black people because it's alot rarer and it's harder to see. Any disease which is rarer and less obvious is going to be caught less often.

Like how flesh eating bacteria is more likely to kill you if you're previously healthy than if you use IV drugs, if only because doctors are paranoid about flesh eating bacteria if they know you use IV drugs.

The pain stuff though is definitely something that needs to change.
 
Are there even many incidents of melanoma in black people?

I mean, I honestly didn't even think black people could get skin cancer. Sorry if that sounds ignorant.
 
This is a bit tricky because 1: in medical schools students are for sure taught about racial differences in cancer and other diseases. But medical school is not where you get practical training on identification on real patients. 2: in residency you gain the practical knowledge, but it seems black patients are underrepresented at derm practices.

The fact that 50% were not taught to specifically identify cancer on black skin in med school isn't ideal, but it isn't something worthy of outrage either. If be surprised if med students could accurately identify specific cancers in most patients overall.

Still a lot us being done on bridging racial gaps in healthcare and a lot more is needed.
 
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