According to The Huffington Post, a recent study published in the Journal of Pain and Symptom Management points to a difference in care exhibited toward black patients nearing the end of life, as opposed to that of white patients.

The Huffington Post reported that 33 hospital-based doctors from Pennsylvania were involved in a study, the details of which were unknown to them.

In this study, actors portrayed hospital patients that were near death. Each “patient” was accompanied by a second actor, portraying a family member. In this sampling, there were no major inadequacies in what was said to black patients versus white patients but, rather, the manner in which statements were made.

According to the study’s senior author, Dr. Amber E. Barnato, “Although we found that physicians said the same things to their black and white patients, communication is not just the spoken word. It also involves nonverbal cues, such as eye contact, body positioning, and touch.”

While communicating with white patients, doctors stood close to the patient’s bedside, some touching the patient in a compassionate manner. Dealing with black patients, doctors remained standing by the door of the hospital room, some with a binder in hand, signifying defense and lack of engagement.

“The researchers analyzed audio and video recordings of the interactions and gave each doctor a score for his or her nonverbal behavior. On average, the doctors scored 7 percent lower for their interactions with blacks than for their interactions with whites,” reports The Huffington Post.

Barnato explains the treatment of black patients saying,

“Poor nonverbal communication—something the physician may not even be aware he or she is doing—could explain why many black patients perceive discrimination in the health care setting.”

A similar study reported in September of 2015, suggests black children are less likely to receive painkillers in the emergency room, than white children, finding that “only about half of any of the kids got painkillers, even though they’re strongly recommended in cases of appendicitis.”

“The findings are not surprising,” according to Dr. Eric Fleegler and Dr. Neil Schechter of Boston Children’s Hospital and Harvard Medical School. “Other studies have shown biases in giving pain medication and in medical treatment in general. … These findings fit a longstanding pattern. There is a substantial body of evidence documenting health care disparities during the past three decades, including disparities in pain management.”

Dr. Barnato suggests that such disparities offer an explanation as to why many black patients avoid opportunities such as Hospice and opt for more expensive “extraordinary life-saving treatments.” As a result, Barnato strongly encourages doctors to be more self-aware, and compassionate. She believes “the ongoing national conversation about race could help,” and suggests that watching their own actions on video may offer doctors assistance in bridging disparities and lessening racial bias.