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Patient activation reduces effects of implicit bias on doctor–patient interactions

Disparities between Black and White Americans persist in medical treatment and health outcomes. One reason is that physicians sometimes hold implicit racial biases that favor White (over Black) patients. Thus, disrupting the effects of physicians' implicit bias is one route to promoting equitab...

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Autores principales: Gainsburg, Izzy, Derricks, Veronica, Shields, Cleveland, Fiscella, Kevin, Epstein, Ronald, Yu, Veronica, Griggs, Jennifer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: National Academy of Sciences 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9371681/
https://www.ncbi.nlm.nih.gov/pubmed/35914161
http://dx.doi.org/10.1073/pnas.2203915119
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author Gainsburg, Izzy
Derricks, Veronica
Shields, Cleveland
Fiscella, Kevin
Epstein, Ronald
Yu, Veronica
Griggs, Jennifer
author_facet Gainsburg, Izzy
Derricks, Veronica
Shields, Cleveland
Fiscella, Kevin
Epstein, Ronald
Yu, Veronica
Griggs, Jennifer
author_sort Gainsburg, Izzy
collection PubMed
description Disparities between Black and White Americans persist in medical treatment and health outcomes. One reason is that physicians sometimes hold implicit racial biases that favor White (over Black) patients. Thus, disrupting the effects of physicians' implicit bias is one route to promoting equitable health outcomes. In the present research, we tested a potential mechanism to short-circuit the effects of doctors’ implicit bias: patient activation, i.e., having patients ask questions and advocate for themselves. Specifically, we trained Black and White standardized patients (SPs) to be “activated” or “typical” during appointments with unsuspecting oncologists and primary care physicians in which SPs claimed to have stage IV lung cancer. Supporting the idea that patient activation can promote equitable doctor–patient interactions, results showed that physicians’ implicit racial bias (as measured by an implicit association test) predicted racially biased interpersonal treatment among typical SPs (but not among activated SPs) across SP ratings of interaction quality and ratings from independent coders who read the interaction transcripts. This research supports prior work showing that implicit attitudes can undermine interpersonal treatment in medical settings and provides a strategy for ensuring equitable doctor–patient interactions.
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spelling pubmed-93716812023-02-01 Patient activation reduces effects of implicit bias on doctor–patient interactions Gainsburg, Izzy Derricks, Veronica Shields, Cleveland Fiscella, Kevin Epstein, Ronald Yu, Veronica Griggs, Jennifer Proc Natl Acad Sci U S A Social Sciences Disparities between Black and White Americans persist in medical treatment and health outcomes. One reason is that physicians sometimes hold implicit racial biases that favor White (over Black) patients. Thus, disrupting the effects of physicians' implicit bias is one route to promoting equitable health outcomes. In the present research, we tested a potential mechanism to short-circuit the effects of doctors’ implicit bias: patient activation, i.e., having patients ask questions and advocate for themselves. Specifically, we trained Black and White standardized patients (SPs) to be “activated” or “typical” during appointments with unsuspecting oncologists and primary care physicians in which SPs claimed to have stage IV lung cancer. Supporting the idea that patient activation can promote equitable doctor–patient interactions, results showed that physicians’ implicit racial bias (as measured by an implicit association test) predicted racially biased interpersonal treatment among typical SPs (but not among activated SPs) across SP ratings of interaction quality and ratings from independent coders who read the interaction transcripts. This research supports prior work showing that implicit attitudes can undermine interpersonal treatment in medical settings and provides a strategy for ensuring equitable doctor–patient interactions. National Academy of Sciences 2022-08-01 2022-08-09 /pmc/articles/PMC9371681/ /pubmed/35914161 http://dx.doi.org/10.1073/pnas.2203915119 Text en Copyright © 2022 the Author(s). Published by PNAS. https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Social Sciences
Gainsburg, Izzy
Derricks, Veronica
Shields, Cleveland
Fiscella, Kevin
Epstein, Ronald
Yu, Veronica
Griggs, Jennifer
Patient activation reduces effects of implicit bias on doctor–patient interactions
title Patient activation reduces effects of implicit bias on doctor–patient interactions
title_full Patient activation reduces effects of implicit bias on doctor–patient interactions
title_fullStr Patient activation reduces effects of implicit bias on doctor–patient interactions
title_full_unstemmed Patient activation reduces effects of implicit bias on doctor–patient interactions
title_short Patient activation reduces effects of implicit bias on doctor–patient interactions
title_sort patient activation reduces effects of implicit bias on doctor–patient interactions
topic Social Sciences
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9371681/
https://www.ncbi.nlm.nih.gov/pubmed/35914161
http://dx.doi.org/10.1073/pnas.2203915119
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