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Harvard Study Examines Hidden Biases Among ER Physicians

A new Harvard University study reports that physicians’ subconscious racial biases play a significant role in the care and treatment they provide to patients and is a contributing factor to the health disparity that exists between Black and White patients.

“We have a very serious problem in health care today,” says Dr. Alexander Green, the leading author of the study. “It has become very clear that minority patients are less likely to get certain important tests and treatments than White patients.”

The study examined the actions of nearly 300 resident physicians in Atlanta and Boston as they determined the best method of care for patients suffering from heart disease, the number one killer of Blacks.

First, the study participants were presented with the medical histories and images of either a 50-year-old Black or White man and asked how they would treat each patient if the patient showed up in the emergency room complaining of chest pains.

Researchers then asked the doctors, depending on their initial response, whether they would diagnose the man as a heart attack victim and, if so, whether they would prescribe thrombolytics, drugs commonly used to treat heart attacks.

The study also had doctors take the Implicit Association Test, a computer survey that detects hidden biases. Dr. Mahzarin Banaji, a psychology professor at Harvard and a co-author of the study, co-designed the test. It was first introduced in 1998 and is widely used to measure unconscious biases.

The result of the study showed that White physicians were less likely to prescribe potentially life-saving medications or treatments to Black heart attack patients.

However, Black physicians were consistent in the care they provided for their patients.

The study, “Implicit Bias Among Physicians and Its Prediction of Thrombolysis Decisions for Black and White Patients,” is the first time the Implicit Association Test has been used to measure unconscious bias among physicians.

The study was published online in the Journal of General Internal Medicine last month.

“We hope to make physicians more aware that these biases exist and that their biases might affect their decisions so that they will be more open to reflect on their biases,” says Green, “and it will open the door on more training programs and other interventions to help overcome these biases.” 

– Margaret Kamara


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