The DOI matches its Crossref record; 63 of the 67 references it cites were found in a registry or an index.
Clinicians' Implicit Ethnic/Racial Bias and Perceptions of Care Among Black and Latino Patients
Open accessAbstract
PURPOSE: We investigated whether clinicians' explicit and implicit ethnic/racial bias is related to black and Latino patients' perceptions of their care in established clinical relationships. METHODS: We administered a telephone survey to 2,908 patients, stratified by ethnicity/race, and randomly selected from the patient panels of 134 clinicians who had previously completed tests of explicit and implicit ethnic/racial bias. Patients completed the Primary Care Assessment Survey, which addressed their clinicians' interpersonal treatment, communication, trust, and contextual knowledge. We created a composite measure of patient-centered care from the 4 subscales. RESULTS: Levels of explicit bias were low among clinicians and unrelated to patients' perceptions. Levels of implicit bias varied among clinicians, and those with greater implicit bias were rated lower in patient-centered care by their black patients as compared with a reference group of white patients (P = .04). Latino patients gave the clinicians lower ratings than did other groups (P <.0001), and this did not depend on the clinicians' implicit bias (P = .98). CONCLUSIONS: This is among the first studies to investigate clinicians' implicit bias and communication processes in ongoing clinical relationships. Our findings suggest that clinicians' implicit bias may jeopardize their clinical relationships with black patients, which could have negative effects on other care processes. As such, this finding supports the Institute of Medicine's suggestion that clinician bias may contribute to health disparities. Latinos' overall greater concerns about their clinicians appear to be based on aspects of care other than clinician bias.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“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 [44]
The cited source says what the claim attributes to it.
In the citing paper
“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 [44]
The cited source says what the claim attributes to it.
In the citing paper
“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 [44]
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Four studies included participants who were not trained physicians or nurses and failed to report separate results for these categories of participants [42, 44, 49, 50].”
From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [44]
Experimental — accuracy not yet measuredIn the citing paper
“Both racial and weight-related biases are documented to influence healthcare interactions (18–20).”
From Regional trends and disparities in newer GLP1 receptor agonist initiation among real‐world adult patients eligible for obesity treatment (2025) · cites this paper as [20]
In the citing paper
“These biases can impact how patients communicate with healthcare providers and their willingness to seek treatment for obesity, potentially leading to underutilization of effective treatments like newer AOM (18–20).”
From Regional trends and disparities in newer GLP1 receptor agonist initiation among real‐world adult patients eligible for obesity treatment (2025) · cites this paper as [20]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Crossing the Quality Chasm: A New Health System for the 21st Century
Baker, A. (2001) · BMJ · doi:10.1136/bmj.323.7322.1192 · Cited by 10,779
Measuring individual differences in implicit cognition: the implicit association test
Greenwald, A. G., McGhee, D. E., & Schwartz, J. L. K. (1998) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.74.6.1464 · Cited by 9,210
Crossing the Quality Chasm: A New Health System for the 21st Century
Committee on Quality of Health Care in America (2002) · Journal for Healthcare Quality · doi:10.1111/j.1945-1474.2002.tb00463.x · Cited by 8,508
Unequal treatment: confronting racial and ethnic disparities in health care
(2003) · Choice Reviews Online · doi:10.5860/choice.40-5843 · Cited by 7,043
Understanding and using the Implicit Association Test: I. An improved scoring algorithm.
Greenwald, A. G., Nosek, B. A., & Banaji, M. R. (2003) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.85.2.197 · Cited by 5,815
Capps, L. (2003) · JAMA · doi:10.1001/jama.290.18.2487-b · Cited by 4,558
Crossing the Quality Chasm: A New Health System for the 21st Century
Bloom, B. S. (2002) · JAMA · doi:10.1001/jama.287.5.646-a · Cited by 3,733
Understanding and using the Implicit Association Test: III. Meta-analysis of predictive validity.
Greenwald, A. G., Poehlman, T. A., Uhlmann, E. L., & Banaji, M. R. (2009) · Journal of Personality and Social Psychology · doi:10.1037/a0015575 · Cited by 3,257
Gawronski, B., & Bodenhausen, G. V. (2006) · Psychological Bulletin · doi:10.1037/0033-2909.132.5.692 · Cited by 2,756
Physician Communication and Patient Adherence to Treatment
Haskard‐Zolnierek, K. B., & DiMatteo, M. R. (2009) · Medical Care · doi:10.1097/mlr.0b013e31819a5acc · Cited by 2,522
Flagged first, then by citations
4 of the 67 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- Montgomery JE, Irish JT, Wilson IB, et al. Primary care experi- ences of Medicare benefi ciaries, 1998 to 2000. J Gen Intern Med. 2004;19(10):991-998.
Cited by
Sorted by citations
Implicit bias in healthcare professionals: a systematic review
FitzGerald, C., & Hurst, S. (2017) · BMC Medical Ethics · doi:10.1186/s12910-017-0179-8 · Cited by 2,556
“In some studies, the attitudes of patients towards healthcare professionals were recorded and used to evaluate clinical interaction [23, 24, 44].”
BackgroundMethodResultInfluentialHall, W. J., Chapman, M. V., Lee, K. M., Merino, Y. M., Thomas, T. W., Payne, B. K., Eng, E., Day, S. H., & Coyne-Beasley, T. (2015) · American Journal of Public Health · doi:10.2105/ajph.2015.302903 · Cited by 2,176
“Black patients perceived poorer treatment in domains such as patient centeredness, contextual knowledge of the patient, and patient---provider communication from providers who demonstrated implicit bias against Blacks on the IAT; Latino patients in the same study did not perceive poorer treatment in these domains, alt…”
ResultHavranek, E. P., Mujahid, M. S., Barr, D. A., Blair, I. V., Cohen, M. S., Cruz-Flores, S., Davey-Smith, G., Dennison-Himmelfarb, C. R., Lauer, M. S., Lockwood, D. W., et al. (2015) · Circulation · doi:10.1161/cir.0000000000000228 · Cited by 1,472
Self-citationMaina, I. W., Belton, T. D., Ginzberg, S. P., Singh, A., & Johnson, T. J. (2017) · Social Science & Medicine · doi:10.1016/j.socscimed.2017.05.009 · Cited by 824
“Additionally, Black patients rated providers with higher pro-White bias more poorly 231 on multiple measures including interpersonal treatmnt, supportive communication, and patient 232 centeredness (Blair et al., 2013b; Penner et al., 2016a).”
BackgroundRacial and Ethnic Disparities in the Quality of Health Care
Fiscella, K., & Sanders, M. R. (2016) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-032315-021439 · Cited by 517
Metadata
- Authors
- Blair, I. V., Steiner, J. F., Fairclough, D. L., Hanratty, R., Price, D. W., Hirsh, H. K., Wright, L. A., Bronsert, M., Karimkhani, E., Magid, D. J., & Havranek, E. P.
- Affiliations
- University of Colorado Boulder (US)
- Kaiser Permanente (US)
- University of Colorado Denver (US)
- Denver Health Medical Center (US)
- ORCID
- Venue
- The Annals of Family Medicine
- Publisher
- Annals of Family Medicine
- Published
- 2013-01-01
- Volume
- 11
- Issue
- 1
- Pages
- 43-52
- ISSN
- 1544-1709 (ISSN-L)
- 1544-1717
- PMC
- PMC3596038
- OpenAlex
- W2137471755
- Cited by
- 409
- References
- 67
- Citations by year
- 2026: 15 · 2025: 27 · 2024: 34 · 2023: 39 · 2022: 43 · 2021: 56 · 2020: 40 · 2019: 38 · 2018: 26 · 2017: 30 · 2016: 24 · 2015: 16 · 2014: 14 · 2013: 7
- FWCI
- 36.64
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- The Annals of Family Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Kaiser Permanente
- University of Colorado Boulder
- University of Colorado Denver
- National Heart, Lung, and Blood Institute (HL088198, R01HL088198)
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Cultural Competency in Health Care
- Keywords
- implicit bias, explicit bias, patient-centered care, patient perception of care, Black patients, Hispanic patients, clinician-patient relationship, health disparities, racial disparities in health care, provider communication, clinician trust
- MeSH terms
- Adolescent, Adult, Black or African American, Colorado, Female, Hispanic or Latino, Humans, Male, Middle Aged, Physician-Patient Relations, Models, Statistical, Patient Satisfaction, Patient-Centered Care, Health Care Surveys, Cultural Competency, Healthcare Disparities, Young Adult, Physicians, Primary Care, Racism
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
