Racial Bias Still Infects the Doctor’s Office

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In medical school, physicians are trained to exclude their own personal upbringings, and that of their patients, from clinical decisions.

That doesn’t always happen in reality.

In fact, doctors are often susceptible to their unconscious bias, research shows.

Unconscious bias, also known as “implicit bias,” happens when automatic processing is influenced by stereotypes. These stereotypes then impact your actions and judgments.

Doctors & Implicit Bias

Many studies have shown that physicians—especially white physicians—have implicit preferences for white patients.

Implicit bias can lead to false assumptions and adverse health outcomes.

For example:

• Implicit bias is a major reason why Latino men are much less likely to receive optimal treatment for high-risk prostate cancer than White men. Uninsured non-Latino white men were 37% less likely to receive definitive treatment than those with insurance and uninsured Latinos were 66% less likely to undergo definitive treatment compared to their insured counterparts.
• Latinas and other pregnant women of color face discrimination from healthcare providers. This is due not only due to their race, but also their socioeconomic background.
• White male physicians are less likely to prescribe pain medications to black patients than white patients.

Evidence shows Latino and other patients of color have better health outcomes with doctors of color.

Yet Latinos and other minorities are profoundly underrepresented in the healthcare workforce as well as clinical research. In fact, the number of Latino doctors declined 22% over the past 30 years while the Latino population rose 243%. Sadly, only 5% of medical school grads are Latinos.

Strategies to Overcome Implicit Bias in Healthcare Settings

Teaching cultural competency can improve healthcare outcomes, and reduce the cost of care and inequities.

Luckily, many efforts are underway to encourage Latinos and other minorities to seek doctoral degrees and healthcare careers such as:

• Éxito! Latino Cancer Research Leadership Training is a program of the Institute for Health Promotion Research (IHPR), the team behind Salud America! at The University of Texas Health Science Center at San Antonio. Éxito! offers an annual summer institute to increase the number of master’s-degree-level Latinos who pursue a doctoral degree. It also has ongoing networking opportunities, and a resource guide for Latinos to apply to and complete a doctoral program.
• Nursing schools all over the country are taking action. Multiple schools have new programs to recruit more Latino students into nursing programs and guide them through completion.
• The National Association of Hispanic Nurses also offers grant programs and scholarship opportunities.
• A law in California is projected to allow students without documentation pursuing medical professions to apply for state scholarships and loan forgiveness programs.
• Free medical school tuition now offered by New York University.

“Affordable medical education, board certification and long-term physician-patient relationships are ways to eliminate bias in medical care” writes cardiologist Lynne Perry-Bottinger in a New York Times op-ed.

“Our profit-driven health system creates limitations in each: Medical school tuition tops $200,000, recertification board exams cost $1,000 each, and most physicians are now employees with limited time for contact with patients.”