Many Doctors Shown to Have Subconscious Racial Attitudes

Newswise — A new U.S. study has found that doctors, like the majority of people who responded, prefer whites to blacks subconsciously, which potentially can affect their ability to provide equal health care to their minority patients.

“The biggest take home is that medical doctors are similar to others, that unconscious attitudes and stereotypes may affect quality of care, and that increased self-awareness may be one way to address any effects unconscious attitudes may have on behaviors that lead to health care disparities,” said lead author Janice Sabin. She is acting assistant professor in the Department of Medical Education and Biomedical Informatics at the University of Washington.

The Institute of Medicine previously found that minorities continue to receive lower quality of care and physicians’ biases and the new study suggests that the inferior care and stereotypes might be related. In the study, which appears in the August issue of the Journal of Health Care for the Poor and Underserved, Sabin and her colleagues used data from 404,277 people who took a test that measured race attitudes online between 2004 and 2006. Of those test-takers, 2,535 were medical doctors of both sexes and diverse racial groups. The race attitude Implicit Association Test (IAT) captures subconscious — or implicit — bias by asking people to associate “good” or “bad” words quickly with photographs of black and white faces. Good words include joy, love, peace and laughter. Bad words include agony, horrible, evil and nasty.

The researchers found that the majority of doctors showed an implicit preference for white Americans compared to black Americans. Black doctors were the exception because they, on average, did not favor either group.

Sabin explained that although bias is common in the general population, people are not “racist” if they “hold an implicit bias.”

“The implicit bias effect among all the test-takers is very strong,” she said. “People who report they have a medical education are not different from other people, and this kind of unconscious bias is a common phenomenon.”

Malcolm Williams, an associate policy researcher at RAND Corporation with an expertise in health disparities, agreed.

“These [unconscious biases] are not unique to physicians,” he said. “Everyone has them. The key is developing a system where quality health care is provided despite such attitudes. This includes increasing access to high-quality care, learning more about how patients and physicians communicate, educating physicians about the barriers their patients face in navigating the systems and educating patients about how to get the most out of their health care encounters.”

Journal of Health Care for the Poor and Underserved: Contact Editor Virginia M. Brennan at (615) 327-6819 or [email protected]. Online, visit http://www.press.jhu.edu/journals/journal_of_health_care_for_the_poor_and_underserved/

Sabin JA, et al. Physicians’ implicit and explicit attitudes about race by MD race, ethnicity, and gender. Journal of Health Care for the Poor and Underserved 20(3), 2009.