Yale Doctor: Body Cameras Could Address Medical Racism Concerns

Dr. Amanda Calhoun has seen it herself in hospitals around the country.

“I was very upset in how bold I felt a lot of the anti-Black, racist statements I’d heard were since really starting as a medical student, frankly, and how common it was and how public it was behind hospital walls,” she said.

Calhoun, a child psychiatry fellow at Yale Child Study Center at the Yale School of Medicine, said she was thinking about the effects of medical racism on patient outcomes when an idea popped into her head: what if medical professionals wore body cameras to provide documentation and create accountability?

“I felt like these people really feel comfortable saying this and it really is going unchecked. People who hear it are either laughing along and think it’s fine or they’re afraid to report it because it’s your word against theirs,” she said. “There’s a lot of power dynamics there.”

Calhoun published an opinion piece in The Emancipator in July calling for doctors and nurses to wear body cameras in hospitals in the same way a growing number of police departments are requiring officers to wear the recording devices. Calhoun said that, although she stands by her idea, she recognizes that there would need to be feedback from stakeholders and a significant amount of planning before such a concept could be implemented; initially, she thinks it would be best as an opt-in pilot at a hospital.

In her column, Calhoun listed a number of ways that health outcomes are worse for Black patients than for white patients, including that Black patients are three times likelier to die from pregnancy-related complications than white patients and that Black children are more likely to be physically restrained in emergency departments than white children. Racist statements and attitudes contribute to and cause these disparities, Calhoun said.

“I think comments like making jokes about a Black child being in a gang definitely trickles down into how they treat that Black child, if they’re diagnosed correctly, how they are viewing that child,” she said.

Dr. Marian Evans, an associate professor of public health at Southern Connecticut State University, said she has encountered racism as a physician and as a patient.

“As a physician I have experienced, been privy to and been in the company of my other colleagues being blatantly racist,” she said. “Dealing with the medical system with my family, I usually make a concerted, intentional effort when I deal with the health care system to initially not tell them I am a physician because I think of the thousands of people who walk through those doors who don’t have the benefit of the knowledge or the skills to advocate that I do for my family. Many times I do have to tell them, which changes the dynamic, and it shouldn’t.”

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Evans is one of several local medical experts who said Calhoun’s proposal is an interesting and unique way of addressing a real concern in the medical field that has led to longstanding unequal care in the health care system.

“I think the true essence of Dr. Calhoun’s writings is that she is trying to move people to do something,” Evans said. “She’s saying there’s a problem with people’s behavior, and the problem with people’s behavior is because of racism and systemic racism we have in our society. Body-worn cameras might be a way to document that.”

Evans said she believes there are critical differences between the role of the police and the role of health care providers, and literature on the lasting effectiveness of body cameras in reducing police misbehavior is inconclusive.

“I think body-worn cameras could be a tool, but whether it is the best use of dollars I would say it would remain to be seen,” she said. “We’d have to go through a period just like we’re doing with body-worn cameras with police.”

Evans said there also are privacy concerns raised by the proposal.

“If you’ve been in the ER or had any type of surgery you know the set-up in the health care system is not the best set-up for privacy at all,” she said. “A curtain screen is not best for privacy; you might not see them, but you can hear them talking.”

Calhoun said she believes HIPAA concerns could be addressed with a consent form.

“In my mind, patients would have the ability to decide whether they wanted their medical team to wear body cameras,” she said.

Further, she said the footage would need to be redacted before it is released to the public, just as it is with police body-camera footage. The advantage of having body-camera footage, she said, largely would be for internal review if were any claims made about misconduct or discrimination. {snip}

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Dr. Lyuba Konopasek, senior associate dean for education at the Frank H. Netter MD School of Medicine at Quinnipiac University and a member of the American Association of Medical Colleges Anti-Racism Task Force, said the idea of equipping health care providers with body cameras is commendable as “an out-of-the-box solution” to an important issue that has troubled medical professionals for a long time. However, she said she has concerns about feasibility to adding a camera to conversations between health care providers and their patients.

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