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Journal article

Medical decision making using knowledge of patient identification as Aboriginal or Torres Strait Islander: what do medical students think?

Cultural awareness Cultural diplomacy Health practitioners Primary health care Indigenous health Australia

Best-practices guidelines require Australian health practitioners to ask all patients “are you [is the person] of Aboriginal and/or Torres Strait Islander origin?”. The present study investigated medical student attitudes regarding medical decisions made after asking this standard status question.

A hypothetical interaction between a doctor and an Aboriginal patient was presented in a pen-and-paper questionnaire in which: (1) the doctor considered (or did not consider) the patient’s Indigenous status relevant to make a medical diagnosis, and the doctor registered (or did not register) the patient for the Closing the Gap PBS co-payment. Participants were first- and second-year medical students at the Australian National University who evaluated the doctor’s decisions against 20 attributes characterising professionalism and prejudice.

Students evaluated the doctor more favourably when the doctor registered the patient for the co-payment and when the doctor did not consider Indigenous status relevant to making a medical diagnosis.

Encouragingly, medical students recognise that withholding registration for the co-payment is unprofessional. At the same time, medical students clearly do not think medical diagnoses should be made using the knowledge a patient identifies as Aboriginal.

With the continual development of policy and guidelines (and the prospect of diagnostic guidelines) to improve Aboriginal and Torres Strait Islander health, students and practitioners must understand how to use this knowledge of a patient’s status to benefit health outcomes.

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