Andrew Benesh’s Reviews > Just Medicine: A Cure for Racial Inequality in American Health Care > Status Update

The conclusion does a good job of summarizing the key points from the book, and the opportunity for structural change to improve minority health care. the connection to other legal theories and precedent was particularly helpful for a non-lawyer reader.

Chapter 9 provides a much clearer legal plan than Chapter 8, with solid reasoning and workable language. The negligence liability model seems appropriate, but I do worry about making policy primarily social science research derivative. Still, the proposals seem solid. The rest of the book is a conclusion and notes; I'll have to explore those later.

Chapter 8 provides a good case for structural changes using a public health model. I wish the proposed legislation would be more explicit - it's one thing to outlaw unconscious racism on paper, and another to do it in practice. Given the courts unfortunate retreat from acknowledging discrimination, I worry about whether such a law could be passed or enforced.

Chapter 7 presents the data I've been looking for the whole book - interventions for reducing implicit bias and their effectiveness. I appreciate the application to the stage model, but wish we were given more real world applications of each type of interventions. Perhaps that's Chapter 8.

Chapter 6 is a remarkably comprehensive literature review of how implicit bias leads to undertreatment by physicians and treatment non-compliance and attrition on patients.

Chapter 5 does a good job of addressing how unconscious bias manifests during a clinical encounter, and provides some tools for combatting it. The criticism of attempts to place responsibility on patients was well executed. The attention to fibroids in this and the preceding chapter is a good illustration of intersectional issues.

I like the model, but I felt a lot of that chapter just repeated summaries of studies that had already been discussed, making it a bit of a slog. I'd like to see more model application, and discussion of strategies for using the model to improve care. Hopefully that's coming soon.

The third chapter provides a strong demonstration of health disparities, and highlights quality research showing how implicit bias leads to poorer patient care in controlled settings. I appreciated the authors attention to factors that can reduce this effect - particularly knowledgeable self correction and the possible influence of more integrative care systems.

The first chapter makes a compelling case for the history of legal discrimination. It's good to be able to vote specific court cases and federal law, but it saddens meeting to see the evisceration of Title VI protections as discrimination became less overt. I look forward to chapter 2!

I've been looking forward to this since a colleague recommended it. Attending to how racism and implicit bias result in health disparities is one of three biggest challenges in modern systems of care, and this book promises a robust analysis.