I'M BIASED: INCREASED PATIENT COMPLIANCE WHEN SURGEONS ADMIT SPECIALTY BIAS

Purpose: Surgeons are more likely to recommend surgery than non-surgeons. In one field study using real doctor-patient interactions and in one lab experiment, we examined the impact on patient trust and likelihood to undergo surgery, specifically a prostatectomy, when patients heard their urologists admit to a specialty bias.

Method: The field study consisted of 243 doctor-patient interactions that were recorded from 4 VA hospitals as part of a study on prostate cancer and in which the treatment outcome of the patient was known. Transcripts from the recordings were coded to record the presence or absence of a bias statement—for example, “I’m a surgeon so I’m biased towards recommending surgery,”—and we examined whether these statements were more likely to be present when patients opted for surgery. The lab experiment consisted of 377 male participants who watched a series of video clips in which a surgeon explained two treatment options for prostate cancer: radiation therapy and surgery. The men were randomized into two conditions—those that heard their urologist admitting their specialty bias in the video clips and those who did not. These men then decided on which treatment they would prefer and their level of trust in the doctor

Result: Patients across the 4 VA hospitals who heard their surgeon admit to a specialty bias (n = 58 out of 243 transcripts) were more likely to take surgery (43%) than those who did not hear their surgeon admit a bias (27%), p = .001. The lab experiment found similar results; participants were more likely to choose surgery if their urologist admitted a specialty bias (87% vs. 68%, p < .01), and these participants also felt increased their trust in the surgeon (p < .05) and felt that their surgeon was more competent (p < .05).

Conclusion: Hearing a doctor openly admit to their specialty bias alters the patients’ perception of the doctor. It increases the patients’ evaluation of the doctor’s skill and competence, their trust in the doctor, and their compliance with the doctor’s biased recommendation.