The Cost of Being Unheard in Washington’s Healthcare System

          Racism in healthcare is “Undeniable, irrefutable—the data is there.” Those were the words of Dr. Benjamin Danielson, one of Seattle’s most respected pediatricians. In 2020, he resigned from Seattle Children’s Hospital, citing years of systemic racism and prejudice against healthcare workers and patients. Last December, a jury awarded him $21 million in non-economic damages. But his victory is not just personal—it’s a wake-up call for Washington’s healthcare system and a reminder that for many patients of color, being unheard can be fatal.

Dr. Benjamin Danielson: 'Profound trauma and joy can coexist ...
Dr. Ben Danielson

              Seattle Children’s delayed the release of its internal racism investigation for over a year—an act that deeply undermined public trust. That investigation reportedly confirmed the very patterns of racial harm that Dr. Danielson and others had long described. During the trial, the jury was presented with evidence of racial discrimination directed not only at Dr. Danielson but also at his colleagues and the hospital’s patients and families. This reveals a critical truth: racism in healthcare is systemic, institutional, and impacts both providers and patients. When hospitals allow these patterns to persist, they not only fail their staff but also endanger the very communities they are meant to serve.

16-year-old Sahana Ramesh’s tragic story reinforces the implicit racial biases embedded in our healthcare institutions. Sahana was a bright and healthy teenager living in Bothell, Washington, when she developed painful rashes and swelling on her face, hands, and feet. Her family urgently took her to the ER at Seattle Children’s Hospital, where she was diagnosed with DRESS—a rare and severe drug reaction. 

Discrimination and negligence at Seattle Children's hospital led to teen's  death, family alleges in lawsuit | CNN
Sahana and her mother

As her symptoms worsened, her parents desperately called the hospital 16 times and sent 22 emails in search of answers. Yet despite Sahana’s exacerbating health and her family’s urgent pleas, they were repeatedly downplayed by clinicians. By the time she and her family were taken seriously, it was too late. Sahana’s death is not an isolated incident—it is part of a pattern in which the concerns of patients of color are too often dismissed or deprioritized. “Evidence shows that if Sahana and her parents had been white, they would have had a better chance of getting admitted to the hospital,” as the Rameshs’ attorney, Martin McLean, asserted. Her story, like Dr. Danielson’s, reveals the life-threatening consequences of implicit bias and institutional neglect.

         These disparities extend beyond emergency care and into specialized fields like dermatology, where racial bias begins in medical training. “Physicians must identify conditions from photos of skin in textbooks or shared in the classroom. But most of the patients in those images are white, and only 4.5% of the images show dark skin,” states dermatologist Jasmine Onyeka Obioha, MD. As a result, clinicians often struggle to diagnose conditions in patients whose appearances and symptoms fall outside of the narrow standards they were taught, leading to higher rates of misdiagnosis among patients of color. In fact, “Women and racial and ethnic minorities are 20% to 30% more likely than white men to experience a misdiagnosis,” said Johns Hopkins professor David Newman-Toker. This becomes especially dangerous in communities like South Seattle, where many families of color reside and access to dermatologists familiar with diverse skin tones remains limited.

        To begin addressing these failures, Washington’s healthcare institutions must change structurally. Hospitals like Seattle Children’s must promote an ethnically inclusive workforce and improve patient advocacy systems—so that when families like Sahana’s speak up, they are heard, regardless of their background or race. Medical schools—including the University of Washington—must diversify their curricula by incorporating diagnostic imagery that equitably represents all skin tones—not just white skin.

      Beyond a legal reckoning, the Seattle Children’s verdict was a stark reflection of the failures embedded in our healthcare institutions. If we don’t respond with urgency and structural reform, we risk repeating the same harm to the patients, families, and communities who need care the most. 

Bibliography

Recht, Hannah. “Misdiagnosed: Women and People of Color Face Widespread Medical Diagnostic Errors.” KFF Health News, 26 Feb. 2024, https://kffhealthnews.org/news/article/medical-misdiagnosis-women-minorities-health-care-bias/.

Cedars-Sinai. “Why Skin Issues in Patients of Color Are Neglected, Mistreated.” Cedars-Sinai Newsroom, 1 Mar. 2023, https://www.cedars-sinai.org/newsroom/why-skin-issues-in-patients-of-color-are-neglected-mistreated/.

Crowder, Madison Wade. “Bothell Family Alleges Racism at Seattle Children’s Hospital in Daughter’s Death.” KING 5 News, 12 Dec. 2023, https://www.king5.com/article/news/investigations/investigators/bothell-family-alleges-racism-seattle-childrens-hospital-daughters-death/281-50d708b3-3b06-422b-a19a-cc3b766d82b6.
Schroeter Goldmark & Bender. “Jury Awards Former Seattle Children’s Doctor $21M in Race Discrimination Lawsuit.” SGB Law, 19 Dec. 2024, https://sgb-law.com/news/jury-awards-former-seattle-childrens-doctor-21m-in-race-discrimination-lawsuit.

Williams, Race and Justice Reporter Erica. “Dr. Ben Danielson Speaks out on Systemic Racism in Health Care.” KING 5 News, 18 Dec. 2020, https://www.king5.com/article/news/community/facing-race/doctor-ben-danielson-seattle-childrens-hospital-systemic-racism-health-care/281-94b16198-3c41-4db8-96d1-1dfc257d98e5.

Why Skin of Color Still Gets Misdiagnosed — and How We Can Fix It

13,400+ Black Man At Doctors Office Stock Photos, Pictures & Royalty-Free  Images - iStock

In 2012, Lauryn Taylor—a Black woman—was misdiagnosed with eczema. Another doctor thought it might be vitiligo. Then came guesses like pityriasis alba or macular hypomelanosis. But none of them were right. In reality, Lauryn had skin cancer—and it took nearly 10 years to get the correct diagnosis.

I'm a Black Woman and My Skin Cancer Was Misdiagnosed for Years
Lauryn Taylor


Let that sink in — for nearly a decade, Lauryn lived with a misdiagnosis while her skin cancer went untreated, simply because her condition wasn’t recognized on darker skin.

Misdiagnosis isn’t just a medical error—it’s a public health crisis with endangering consequences. Diagnosis of the wrong condition can delay the proper treatment, allowing the condition to worsen over time. Dermatologists may prescribe particular creams or medications that can cause irreversible damage.

It’s also emotionally draining. Patients may feel frustrated or anxious when their ‘treatments’ are not working, leaving them feeling hopeless and dismayed. In desperation, patients will keep paying and returning for medical consultations and buying the wrong products/treatments. This becomes a heavy financial burden.

These are licensed physicians, right? Why are so many of them misdiagnosing patients?

“Probably no doctor is intending to do worse on any type of person, but it might be the fact that you don’t have all the knowledge and the experience, and therefore on certain groups of people, you might do worse,” says Northwestern University professor Matt Groh. In fact, it’s not the dermatologists’ fault — it’s the education system. 

“A large part of dermatology education involves visual recognition,” states dermatologist Jasmine Onyeka Obioha, MD. “Physicians must identify conditions from photos of skin in textbooks or shared in the classroom. But most of the patients in those images are white and only 4.5% of the images show dark skin.” As a result, most medical students don’t know how to identify the skin conditions of patients of color, leading to a disparity in misdiagnosis among racially and ethnically diverse populations. 

However, the misrepresentation of racially/ethnically diverse populations extends beyond dermatology textbooks, reflecting a broader, systemic issue within clinical education and diagnostic training. “Women and racial and ethnic minorities are 20% to 30% more likely than white men to experience a misdiagnosis,” said Johns Hopkins professor of neurology David Newman-Toker. This astounding statistic reveals the racial/ethnic disparities embedded in the foundations of medical training. 

It’s no wonder why physicians often struggle to diagnose conditions in patients whose appearances and symptoms fall outside of the narrow standards they were taught.

What can we do?
In order for us to promote racial equality in dermatology/health care and prevent misdiagnoses, we must:


Reform medical education:
As only ~4.5% of dermatology images feature darker skin, we need to bring that number up to at least 30%. This number ensures equitable inclusion and representation of racially and ethnically diverse populations. 

We need to incorporate modules tailored to diagnosing and treating conditions presented by racially and ethnically diverse populations into the medical curriculum.

Advocate for change:
Acknowledging the issue and the devastating statistics is the first step. Now, to turn awareness into action, we must collectively raise our voices, educate others, and advocate for meaningful change. People of color deserve to be treated with dignity and equity in the healthcare system.

Available resources:
https://guides.ucsf.edu/c.php?g=1081119&p=9159811

https://skinofcolorsociety.org/
https://www.aad.org/member/career/diversity

Bibliography:


1. UCSF Library. Health Disparities and Skin of Color in Dermatology. University of California San Francisco, 2022, https://guides.ucsf.edu/c.php?g=1081119&p=9159811.

2 Skin of Color Society. Home. https://skinofcolorsociety.org/.

3. American Academy of Dermatology. Diversity, Equity, and Inclusion in Dermatology. https://www.aad.org/member/career/diversity.

4.  Miller, Korin. “Doctors Told Me My Skin Cancer Was Eczema for Almost a Decade.” Prevention, 28 May 2021, https://www.prevention.com/health/health-conditions/a36230501/mycosis-fungoides-misdiagnosis/.

5. Kim, Sophia, et al. “Diagnostic Performance of Dermatologists and General Practitioners in Skin Diseases on Diverse Skin Tones.” Nature Medicine, vol. 29, 2023, pp. 1941–1948. https://www.nature.com/articles/s41591-023-02728-3.

6. Loftus, Peter. “Misdiagnosed: Women and Minorities Face Higher Risk of Harm from Medical Errors.” KFF Health News, 15 Dec. 2023, https://kffhealthnews.org/news/article/medical-misdiagnosis-women-minorities-health-care-bias/.

7. Cedars-Sinai. “Why Skin Issues in Patients of Color Are Neglected, Mistreated.” Cedars-Sinai Newsroom, https://www.cedars-sinai.org/newsroom/why-skin-issues-in-patients-of-color-are-neglected-mistreated/.

8. Pew Research Center. Facts About the U.S. Black Population. 9 Feb. 2023, https://www.pewresearch.org/race-and-ethnicity/fact-sheet/facts-about-the-us-black-population/.

9. Massachusetts General Hospital. Skin Assessment in Patients with Dark Skin Tone. Munn Center, Apr. 2023, https://www.mghpcs.org/MunnCenter/Documents/weekly/apr-23/Skin-Assessment-in-Patients-with-Dark-Skin-Tone.pdf.

10. Trafton, Anne. “Doctors Struggle to Diagnose Diseases in Patients with Darker Skin.” MIT News, 5 Feb. 2024, https://news.mit.edu/2024/doctors-more-difficulty-diagnosing-diseases-images-darker-skin-0205.

11. TEDx Talks. “Why Doctors Misdiagnose Skin Conditions on Darker Skin.” YouTube, uploaded by TEDx, 7 Oct. 2022, https://www.youtube.com/watch?v=2JUQo-PnY2g.