Unconscious Race and Social Class Bias Among Acute Care Surgical Clinicians and Clinical Treatment Decisions

Abstract

Unconscious social class and race biases were not significantly associated with clinical decision making among acute care surgical clinicians. Further studies involving real physician-patient interactions may be warranted.

Examining the presence, consequences, and reduction of implicit bias in health care: A narrative review

“…Consistent with other populations, health care providers demonstrate implicit biases indicative of more negative attitudes toward African Americans than Whites (Blair et al, 2013a; Cooper et al, 2012; Green et al, 2007; Haider et al, 2011, 2015a, 2015b; Hausmann et al, 2015; Oliver, Wells, Joy-Gaba, Hawkins, & Nosek, 2014; Sabin, Nosek, Greenwald, & Rivara, 2009; Schaa, Roter, Biesecker, Cooper, & Erby, 2015; Stepanikova, 2012; for null effects, see Penner et al, 2010; Sabin, Rivara, & Greenwald, 2008), more negative attitudes toward Latinos than Whites (Blair et al, 2013a, 2013b; Stepanikova, 2012), and somewhat more negative attitudes toward Native Americans than Whites (Sabin, Moore, Noonan, Lallemand, & Buchwald, 2015). Health care providers also exhibit negative implicit biases against overweight/obese individuals (Phelan et al, 2014; Sabin, Marini, & Nosek, 2012; Teachman & Brownell, 2001; Waller, Lampman, & Lupfer-Johnson, 2012), gay and lesbian people (Burke et al, 2015; Sabin, Riskind, Nosek, 2015), lower social class (Haider et al, 2011, 2015a, 2015b), injecting drug users (von Hippel, Brener, & von Hippel, 2008), and wheelchair users with spinal cord injuries (Galli, Lenggenhager, Scivoletto, Molinari, & Pazzagila, 2015).…”

Racial and Ethnic Disparities in the Quality of Health Care

“…Implicit clinician racial bias has garnered the most attention. For routine care, there is relatively little evidence that physician bias affects recommendations for patients based on race and ethnicity (16,33,58,61,124). Clinician habits may mitigate implicit clinician bias when care is highly routinized.…”

Race/ethnicity and Americans’ experiences with treatment decision making

“…Most prior research has focused on the possible effects of bias on disparities in treatment decisions concerning minority patients [17][18][19][20]. Thus, more evidence is needed about the potential effects of biases on clinical communication, which may further influence building of trust and partnership during medical encounters.…”