Document Detail

Clinicians' implicit ethnic/racial bias and perceptions of care among Black and Latino patients.
MedLine Citation:
PMID:  23319505     Owner:  NLM     Status:  MEDLINE    
PURPOSE: We investigated whether clinicians' explicit and implicit ethnic/racial bias is related to black and Latino patients' perceptions of their care in established clinical relationships.
METHODS: We administered a telephone survey to 2,908 patients, stratified by ethnicity/race, and randomly selected from the patient panels of 134 clinicians who had previously completed tests of explicit and implicit ethnic/racial bias. Patients completed the Primary Care Assessment Survey, which addressed their clinicians' interpersonal treatment, communication, trust, and contextual knowledge. We created a composite measure of patient-centered care from the 4 subscales.
RESULTS: Levels of explicit bias were low among clinicians and unrelated to patients' perceptions. Levels of implicit bias varied among clinicians, and those with greater implicit bias were rated lower in patient-centered care by their black patients as compared with a reference group of white patients (P = .04). Latino patients gave the clinicians lower ratings than did other groups (P <.0001), and this did not depend on the clinicians' implicit bias (P = .98).
CONCLUSIONS: This is among the first studies to investigate clinicians' implicit bias and communication processes in ongoing clinical relationships. Our findings suggest that clinicians' implicit bias may jeopardize their clinical relationships with black patients, which could have negative effects on other care processes. As such, this finding supports the Institute of Medicine's suggestion that clinician bias may contribute to health disparities. Latinos' overall greater concerns about their clinicians appear to be based on aspects of care other than clinician bias.
Irene V Blair; John F Steiner; Diane L Fairclough; Rebecca Hanratty; David W Price; Holen K Hirsh; Leslie A Wright; Michael Bronsert; Elhum Karimkhani; David J Magid; Edward P Havranek
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Annals of family medicine     Volume:  11     ISSN:  1544-1717     ISO Abbreviation:  Ann Fam Med     Publication Date:    2013 Jan-Feb
Date Detail:
Created Date:  2013-01-15     Completed Date:  2013-06-25     Revised Date:  2014-05-29    
Medline Journal Info:
Nlm Unique ID:  101167762     Medline TA:  Ann Fam Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  43-52     Citation Subset:  IM    
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MeSH Terms
African Americans / psychology*
Cultural Competency
Health Care Surveys
Healthcare Disparities / ethnology
Hispanic Americans / psychology*
Middle Aged
Models, Statistical
Patient Satisfaction / ethnology*,  statistics & numerical data
Patient-Centered Care*
Physician-Patient Relations*
Physicians, Primary Care / psychology*
Racism / psychology*
Young Adult
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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