18 Mar Clinicians’ Race and Social Biases Did Not Affect Patient Clinical Care

MedicalResearch.com Interview with:
Dr. Adil Haider, MD, MPH
Kessler Director of the Center for Surgery and Public Health (CSPH)
at Brigham and Women’s Hospital

Medical Research: What is the background for this study?

Response: Disparities in the quality of care received by minority and low-income patients have been reported for years across multiple medical conditions, types of care, and institutions. 

To determine whether clinicians’ unconscious race and/or social class biases correlated with a lower quality of care for minority patients and those of lower socioeconomic status, my colleagues and I conducted a web-based survey among 215 physicians at an academic, level one trauma center. Participants were asked to review eight clinical vignettes, and then respond to three questions about management of care after each. Following their response, a test known as an Implicit Association Test (IAT Test) was used to assess any unconscious preferences.

Medical Research: What are the main findings?

Response: We found that race and class biases, as measured by response time to a standardized Implicit Association Test, had no relationship to the way that patients were clinically treated.

Whether the lack of association found between implicit bias and decision making in this study represents a true lack of association or the failure of clinical vignettes to capture the nuances of how implicit biases translate into management decisions remains unclear. Existing biases might influence the quality of care received by minority patients and those of lower socioeconomic status in real-life clinical encounters.

Medical Research: What should clinicians and patients take away from your report?

Response: Clinicians should be aware of their own implicit biases, to the extent that it’s possible, and seek to understand the way that these biases may affect our everyday practice. One way that we’ve attempted to account for biases is by creating surgical checklists and other mechanisms to ensure that the care we provide each patient is the same. These findings could support the effectiveness of these mechanisms, at least in this setting, and could point to larger systemic factors (insurance, access to care, etc.) as the root cause of disparities in surgical care.

Patients should rest assured knowing that researchers are doing our best to understand what existing unconscious race and social class biases exist, how they affect clinical decision making, and what can be done to eliminate surgical disparities. Our focus is on providing research that can then result in policies and procedures to ensure that every patient receives the best, most person-centered care possible.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Further research using data from actual clinical interactions is warranted to clarify the effect of clinician implicit bias on the provision of health care and outcomes.

Citation:

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MedicalResearch.com Interview with: Dr. Adil Haider, MD, MPH (2015). Clinicians’ Race and Social Bias Did Not Affect Patient Clinical Care

Last Updated on March 18, 2015 by Marie Benz MD FAAD