Race-Based Medicine

Differential Diagnosis

-Analysis

This case is designed to have the learner explore their implicit clinical assumptions and consider how they perceive or use the race of their patient in clinical practice. You may consider how you obtain information about your patient’s race and genetic ancestry in the clinic. Race factors into the way several tests are evaluated, including spirometry for lung function and estimated GFR for renal function. Though these differences may have their origins in false beliefs about race-based biological differences in lung capacity and muscle mass, they are used in current practice.

Many thoughtful people in medicine are grappling with how to use race and racial identity in medicine. While it is clear that race is not a valid proxy for genetic ancestry, it does provide information about the lived experience of people with marginalized identities, the impact of stress on health, and possibly epigenetic changes in response to chronic stress. More to come on addressing the impact of racism-related stress ahead.