The woman was desperate by the time she arrived in Lucy Schulson's exam room. Patches of itchy blisters had spread across her skin. Other doctors had assured her it was nothing, a skin infection, and had sent her home with creams to soothe the itch. They had not worked.

Schulson wasn't sure what it was, either. But she knew the woman needed to see a dermatologist immediately. She would later learn the woman, who was Black, had a rare autoimmune disorder that attacks the skin, “a pretty terrible thing to live with.” She suspected race may have played a role in the delayed diagnosis and treatment.

Schulson, an internist at Boston Medical Center and a physician policy researcher at RAND, had just finished a study of what the medical field calls “patient safety events.” The term can cover any number of medical harms, from bad drug interactions to surgical site infections to missed diagnoses for a persistent rash. The study found clear and consistent evidence that minoritized patients are at especially high risk. But the way the health care system tracks patient safety too often makes them and their experiences invisible.

It became clear that even if we have the technology, and we have the science, and we have the medicine, that's not sufficient to address all these underlying structural issues that lead to the disparities we see,” Schulson said. “We need to start thinking differently about this, and that starts by naming the problem for what it is, which is racism.”

Schulson and her team read back through nearly 20 years of medical studies and interviewed more than a dozen top medical specialists. They found that Black patients suffer more surgical complications than White patients, even in the same hospital. Black patients also are more likely to experience harmful drug interactions, to go without needed pain medicine, and to die following coronary bypass surgery. Black, Hispanic, Asian, and Native Hawaiian or Pacific Islander patients have much higher rates of hospital-acquired infections.

Read the full article about racism and patient safety at RAND Corporation.