TUESDAY, Mar. 20, 2012 —We’d all like to believe that our doctors can put prejudices aside when choosing the best patient care. But a report published in the American Journal of Public Health suggests that racial bias can influence physician decisions without their being aware of it — even for their youngest patients.
In the study, researchers at the University of Washington asked 86 pediatricians, 82 percent of whom were white, to complete online tests designed to measure unconscious attitudes toward race and other characteristics. (A sample and more information about the tests can be found here.) The participants were then asked to make treatment recommendations for hypothetical white and African-American patients with asthma, ADHD, urinary tract infections, or pain.
There was no link between the test results and treatment decisions for asthma, ADHD, and UTIs. But pediatricians who showed an unconscious pro-white bias when tested were more likely to choose ibuprofen over the more powerful narcotic oxycodone for treating their hypothetical black patient after surgery.
Previous research has also found a connection between race and patient care for pain. A January 2011 report in Pediatric Emergency Care found that children with sickle-cell disease who visited an emergency room were less likely to have their pain assessed than children with fractures; sickle-cell disease is much more common in African Americans. Similarly, a 2007 article in Academic Emergency Medicine found that African-American men visiting an emergency room for chest pain were up to 30 percent less likely to receive diagnostic tests such as cardiac monitoring and chest X-rays. And University of Michigan Health System researchers studying patients referred to a pain specialty clinic found that black patients were taking nearly half the number of pain medications compared with white patients; the report was published in the August 2010 issue of the Journal of Pain.
In a press release , Janice Sabin, PhD, stressed that the physicians studied in the American Journal of Public Health report were unaware of their biases. “Because these are unconscious attitudes, doctors aren't aware that their racial attitudes may affect their treatment decisions," said Dr. Sabin, assistant professor at the University of Washington School of Medicine and lead author of the study. But, she added, more research needs to be done to see how these biases influence real-world treatment, especially for pain.
Last Updated: 3/20/2012