Physician implicit attitudes and stereotypes about race and quality of medical care
- PMID: 18580386
- DOI: 10.1097/MLR.0b013e3181653d58
Physician implicit attitudes and stereotypes about race and quality of medical care
Abstract
Background: Recent reports speculate that provider implicit attitudes about race may contribute to racial/ethnic health care disparities.
Objectives: We hypothesized that implicit racial bias exists among pediatricians, implicit and explicit measures would differ and implicit measures may be related to quality of care.
Research design: A single-session, Web survey of academic pediatricians in an urban university measured implicit racial attitudes and stereotypes using a measure of implicit social cognition, the Implicit Association Test (IAT). Explicit (overt) attitudes were measured by self-report. Case vignettes were used to assess quality of care.
Results: We found an implicit preference for European Americans relative to African Americans, which was weaker than implicit measures for others in society (mean IAT score = 0.18; P = 0.01; Cohen's d = 0.41). Physicians held an implicit association between European Americans relative to African Americans and the concept of "compliant patient" (mean IAT score = 0.25; P = 0.001; Cohen's d = 0.60) and for African Americans relative to European Americans and the concept of "preferred medical care" (mean IAT score =-0.21; P = 0.001; Cohen's d = 0.64). Medical care differed by patient race in 1 of 4 case vignettes. No significant relationship was found between implicit and explicit measures, or implicit measures and treatment recommendations.
Conclusions: Pediatricians held less implicit race bias compared with other MDs and others in society. Among pediatricians we found evidence of a moderate implicit "perceived patient compliance and race" stereotype. Further research is needed to explore whether physician implicit attitudes and stereotypes about race predict quality of care.
Similar articles
-
Clinicians' Implicit and Explicit Attitudes about Weight and Race and Treatment Approaches to Overweight for American Indian Children.Child Obes. 2015 Aug;11(4):456-65. doi: 10.1089/chi.2014.0125. Epub 2015 Jul 17. Child Obes. 2015. PMID: 26186413 Free PMC article.
-
Do physicians' implicit views of African Americans affect clinical decision making?J Am Board Fam Med. 2014 Mar-Apr;27(2):177-88. doi: 10.3122/jabfm.2014.02.120314. J Am Board Fam Med. 2014. PMID: 24610180 Clinical Trial.
-
Physicians' implicit and explicit attitudes about race by MD race, ethnicity, and gender.J Health Care Poor Underserved. 2009 Aug;20(3):896-913. doi: 10.1353/hpu.0.0185. J Health Care Poor Underserved. 2009. PMID: 19648715 Free PMC article.
-
Race and racism in nursing research: past, present, and future.Annu Rev Nurs Res. 2004;22:9-37. Annu Rev Nurs Res. 2004. PMID: 15368766 Review.
-
Racial and ethnic disparities in the emergency department: a public health perspective.Emerg Med Clin North Am. 2006 Nov;24(4):905-23. doi: 10.1016/j.emc.2006.06.009. Emerg Med Clin North Am. 2006. PMID: 16982346 Review.
Cited by 82 articles
-
Ethnicity and insurance status predict metastatic disease presentation in prostate, breast, and non-small cell lung cancer.Cancer Med. 2020 Aug;9(15):5362-5380. doi: 10.1002/cam4.3109. Epub 2020 Jun 8. Cancer Med. 2020. PMID: 32511873 Free PMC article.
-
Are Children's Hospitals Unique in the Community Benefits They Provide? Exploring Decisions to Prioritize Community Health Needs Among U.S. Children's and General Hospitals.Front Public Health. 2020 Feb 27;8:47. doi: 10.3389/fpubh.2020.00047. eCollection 2020. Front Public Health. 2020. PMID: 32175301 Free PMC article.
-
Association of Simulated Patient Race/Ethnicity With Scheduling of Primary Care Appointments.JAMA Netw Open. 2020 Jan 3;3(1):e1920010. doi: 10.1001/jamanetworkopen.2019.20010. JAMA Netw Open. 2020. PMID: 31995215 Free PMC article.
-
Contributions of Geography and Nongeographic Factors to the White-Black Gap in Hospital Quality for Coronary Heart Disease: A Decomposition Analysis.J Am Heart Assoc. 2019 Dec 3;8(23):e011964. doi: 10.1161/JAHA.119.011964. Epub 2019 Nov 30. J Am Heart Assoc. 2019. PMID: 31787056 Free PMC article.
-
Pre-clinical medical student reflections on implicit bias: Implications for learning and teaching.PLoS One. 2019 Nov 15;14(11):e0225058. doi: 10.1371/journal.pone.0225058. eCollection 2019. PLoS One. 2019. PMID: 31730651 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
-
Full Text Sources
-
Other Literature Sources
-
Medical
-
Research Materials
-
Miscellaneous