Letter to the Editor: Disclosing Race in Case Reports

        Dear Editor,
        Thank you for the instructive case reports of young people in long-term care in the May, 2021 issue (Caring for the Ages 2021, 22(4): 10-11; I noticed that the person’s race was documented at the beginning of the report. Specifying the race of the patient in the opening sentence of the physical exam was a habit that I picked up in medical school. I have discontinued this habit in answer to the call of the Massachusetts Medical Society leadership to be anti-racist.
        An article by Johns Hopkins geriatrician Thomas E. Finucane, MD, a frequent contributor to publications of AMDA – The Society for Post-Acute and Long-Term Care, addresses the proper place of race and ethnicity in our case presentations (AMA J Ethics 2014, 16(6): 423-427; Dr. Finucane advises that identifying race/ethnicity simply by observation may be more a manifestation of prejudice than observational data. It is best to ask the patient what group they identify with and then to record it in the social history. While perceived race certainly affects life experience, we are learning that race is a social, rather than genetic, construct.
        Eric Reines, MD, FACP, Marblehead, MA
        Dear Dr. Reines,
        Thank you for raising this important question. The editors of Caring for the Ages asked the Diversity and Inclusion Workgroup of AMDA – The Society for Post-Acute and Long-Term Care Medicine to discuss your query and return an opinion. After much discussion, the consensus was that, while there is not a simple answer to the question you raised, the racial and ethnic identity of a patient in long-term care is an important cultural element essential to understanding a case in its entirety.
        In contrast to outpatient clinical settings or inpatient hospital units, long-term care settings serve as a home for their residents, a place where their racial and ethnic identity plays an important role. Knowing race and ethnicity is also vital in providing person-centered care. The Workgroup has concluded that race should be included in reports of cases in long-term care.
        Members of the workgroup felt this was an important discussion that went well beyond case reports into all clinical assessments. They proposed having this be a topic for a panel discussion at the Society’s 2022 Annual Conference, and perhaps a workshop on cultural competency in clinical assessments in PALTC medicine.
        Christopher Laxton, CAE
        Executive director of AMDA – The Society for Post-Acute and Long-Term Care Medicine