Letter from MDAdvantage® Chairman and CEO Patricia A. Costante
I am pleased to release our latest issue of MDAdvisor, which includes articles that we have been working on since before the COVID-19 pandemic started.
One topic that we continue to focus on in the journal is the opioid epidemic, which has worsened with the emergence of COVID-19. Widespread shutdowns and social distancing measures have made it difficult for those seeking guidance and treatment for substance abuse issues to access resources. Because of this, substance abuse has become more prominent across the United States, where we have seen a recent surge in alcohol sales and addiction relapses.
Although the article “New Jersey’s Response to the Opioid Epidemic” indicates the rate of opioid prescriptions has declined overall among New Jersey physicians, evidence on the national level continues to show that doctors in the United States are still prescribing opioids at dangerously high rates. Our continuing medical education (CME) article for this issue is an important one. “Words Matter: Addressing Implicit Bias in Treatment of Opioid Use Disorder” seeks to reduce the social stigma attached to substance abuse disorders by increasing awareness of the biases that exist regarding substance abusers.
We continue to cover topics relating to COVID-19, including an article by the New Jersey Department of Health on vaccine hesitancy, an issue that could pose a major barrier to protecting individuals from COVID-19 should a SARS-CoV-2 vaccine become available. We have also added to the MDAdvantage podcast series that accompanies our journal. These podcasts provide informative discussions on current topics, including COVID-19 and its impact on physicians and physician practices. I encourage you to listen to our latest interviews, available at mdadvantageonline.com/education-advocacy/podcasts/.
I hope all of you are staying safe and healthy. Our fall issue is right around the corner—it will be a themed issue focusing on cybersecurity in the healthcare environment.
Chairman & CEO
MDAdvantage Insurance Company
Table of Contents
News & Acknowledgements
To the Editor,
I would like to thank Drs. Chen, Traba, Soto-Greene and Lamba for the article “Words Matter: Addressing Implicit Bias in the Treatment of Opioid Use Disorder.” The authors present a compelling case that, yes, words do matter—whether attached to the stereotypes surrounding opioid use disorder or other conditions.
While it may seem that the topic of implicit bias has gained attention only recently, the 2003 Institute of Medicine Report “Unequal Treatment” concluded that “even when access-to-care barriers such as insurance and family income were controlled for, racial and ethnic minorities received worse healthcare than nonminorities and that both explicit and implicit bias played potential roles.” Since this report, there has been a growing body of research demonstrating that implicit bias can challenge the doctor-patient relationship with black patients. One study entitled “The Associations of Clinicians’ Implicit Attitudes About Race with Medical Visit Communication and Patient Ratings of Interpersonal Care” by Lisa A. Cooper and colleagues found that physicians who score highly on implicit bias tests are more likely to dominate conversations with black patients than were those lower in implicit bias and that black patients trusted them less.
In the setting of cancer care, Louis A. Penner and colleagues reported in 2016 that physicians scoring high in implicit bias tests were less supportive of and spent less time with their black patients than providers low in implicit bias. Black patients viewed high-implicit-bias physicians as less patient-centered than physicians low in this bias. The patients also had more difficulty remembering what their physicians told them, had less confidence in their treatment plans and thought it would be more difficult to follow recommended treatments.
Addressing implicit bias is one step toward achieving health equity. To quote author and motivational speaker Zig Ziglar, “The first step in solving a problem is to recognize that it does exist.”
David S. Kountz, MD, MBA, FACP, Co-Chief Academic Officer, Hackensack Meridian Health
Professor and Associate Dean, Diversity and Equity, Hackensack Meridian School of Medicine