ARE PATIENTS BIASED AGAINST MINORITY AND FEMALE PHYSICIANS? EVIDENCE THAT BIAS PREDICTS PHYSICIAN EVALUATIONS

Purpose: After a medical visit, patients are often asked to evaluate their physician. These evaluations are used to monitor physician performance and patient satisfaction. However, patients may have pre-existing biases that might unduly influence their evaluation of racial minority and female physicians. Two studies examined the role of racial bias (Study 1) and gender bias (Study 2) in evaluations of minority and female physicians.

Method: In both studies, college students were asked to take the role of a patient while reading a vignette in which a doctor attempted to diagnose their persistent cough. In Study 1 (N=203) the doctor in the vignette was either portrayed as an Arab or White male, using different surnames. Participants then evaluated the doctor and the visit. To measure their level of implicit bias against people of Arab descent, participants then completed an Implicit Association Test (IAT; Greenwald, Nosek, & Banaji, 2003). In Study 2 (N=61), the doctor was either portrayed as a White female or male. Participants then evaluated the doctor and the visit and completed a measure of their gender bias.

Result: In Study 1, participants who read about a physician with an Arab surname rated him as less thorough (p=.006), lower in physician quality (intelligence, diagnostic ability, and professionalism, alpha=.86, p=.023) and gave him a lower overall grade (p=.006) compared to participants who evaluated a White physician. Participants also expressed less trust in their Arab physician (p=.032), and marginally less satisfaction with his treatment (p=.087). The negative evaluations of the physician with an Arab surname were significantly predicted by participants’ implicit bias against people of Arab descent (p=.03).

In Study 2, relative to female participants, male participants rated the female physician as less thorough (p=.008), lower in physician quality (intelligence, diagnostic ability, and professionalism, alpha=.85, p=.016) and gave her a lower overall grade (p=.015) compared to the male physician. The negative evaluations of the female physician were significantly predicted by participants’ gender bias (p=.04).

Conclusion: A growing number of physicians in the U.S. are racial minorities and/or female. Due to patients’ preexisting biases, minority and female physicians may receive poorer evaluations that could negatively, and erroneously, impact their career and ability to effectively practice medicine.