Aversive racism and medical interactions with Black patients: A field study
Open accessAbstract
Medical interactions between Black patients and nonBlack physicians are usually less positive and productive than same-race interactions. We investigated the role that physician explicit and implicit biases play in shaping physician and patient reactions in racially discordant medical interactions. We hypothesized that whereas physicians' explicit bias would predict their own reactions, physicians' implicit bias, in combination with physician explicit (self-reported) bias, would predict patients' reactions. Specifically, we predicted that patients would react most negatively when their physician fit the profile of an aversive racist (i.e., low explicit-high implicit bias). The hypothesis about the effects of explicit bias on physicians' reactions was partially supported. The aversive racism hypothesis received support. Black patients had less positive reactions to medical interactions with physicians relatively low in explicit but relatively high in implicit bias than to interactions with physicians who were either (a) low in both explicit and implicit bias, or (b) high in both explicit and implicit bias.
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Three studies found a significant correlation between high levels of physicians' implicit bias against blacks on IAT scores and interaction that was negatively rated by black patients.
“Three studies found a significant correlation between high levels of physicians’ implicit bias against blacks on IAT scores and interaction that was negatively rated by black patients [23, 24, 44]”
From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [24]
The Results report that greater physician implicit bias predicted less positive ratings from Black patients when physicians’ explicit bias was low (β=−.52, p=.010). This supports the paper as one of the studies cited, but not an unqualified correlation between high IAT bias and negative patient ratings: at high explicit bias, implicit bias had no effect on the patient-response composite (p=.99). (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe only three studies conducted in naturalistic settings combined the IAT with measures of physician-patient interaction.
“The only three studies conducted in naturalistic settings combined the IAT with measures of physician-patient interaction [22–24].”
From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [24]
In some studies, the attitudes of patients towards healthcare professionals were recorded and used to evaluate clinical interaction.
“In some studies, the attitudes of patients towards healthcare professionals were recorded and used to evaluate clinical interaction [23, 24, 44].”
From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [24]
The review shows clearer evidence for a relationship between implicit bias and negative effects on clinical interaction.
“As our review shows, there is clearer evidence for a relationship between implicit bias and negative effects on clinical interaction [23, 24, 44].”
From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [24]
Black patients provided poorer ratings of the quality of the medical encounter (warmth, friendliness, teamwork and satisfaction) with physicians who were aversive racists (low on explicit bias and high on implicit bias) than with those who were high or low on both explicit and implicit racial bias.
“One study found that black patients provided poorer ratings of the quality of the medical encounter (in terms of warmth, friendliness, teamwork and satisfaction) with physicians who were aversive racists (low on explicit bias and high on implicit bias) than with those who were high or low on both explicit and implicit racial bias [73].”
From Reducing Racial Inequities in Health: Using What We Already Know to Take Action (2019) · cites this paper as [73]
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References 45 · Cited by 394
Research works printed but not linked: 15
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- Authors
- Penner, L. A., Dovidio, J. F., West, T. V., Gaertner, S. L., Albrecht, T. L., Dailey, R. K., & Markova, T.
- Affiliations
- Wayne State University (US)
- Yale University (US)
- New York University (US)
- University of Delaware (US)
- Corresponding author
- Penner, Louis A.
- Venue
- Journal of Experimental Social Psychology
- Publisher
- Elsevier BV
- Published
- 2010-03
- Volume
- 46
- Issue
- 2
- Pages
- 436-440
- ISSN
- 0022-1031 (ISSN-L)
- PMC
- PMC2835170
- OpenAlex
- W2153003445
- Cited by
- 394
- References
- 45
- Citations by year
- 2026: 9 · 2025: 17 · 2024: 24 · 2023: 21 · 2022: 22 · 2021: 36 · 2020: 37 · 2019: 29 · 2018: 28 · 2017: 28 · 2016: 28 · 2015: 24 · 2014: 19 · 2013: 26 · 2012: 24
- FWCI
- 45.46
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Experimental Social Psychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- University Libraries (University of Maryland) (submittedVersion)
- Digital Repository at the University of Maryland (University of Maryland College Park)
- Funders
- National Science Foundation
- University of Virginia
- National Institutes of Health
- National Cancer Institute (U01CA114583)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R21HD050450)
- Topics
- Social Sciences › Sociology and Political Science › Social and Intergroup Psychology
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Keywords
- aversive racism, racial bias in medicine, physician-patient interaction, Black patients, implicit bias, explicit bias, patient reactions
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