title: The associations of clinicians' implicit attitudes about race with medical visit communication and patient ratings of interpersonal care.
abstract: OBJECTIVE
  We examined the associations of clinicians' implicit attitudes about race with visit communication and patient ratings of care.
  
  
  METHODS
  In a cross-sectional study of 40 primary care clinicians and 269 patients in urban community-based practices, we measured clinicians' implicit general race bias and race and compliance stereotyping with 2 implicit association tests and related them to audiotape measures of visit communication and patient ratings.
  
  
  RESULTS
  Among Black patients, general race bias was associated with more clinician verbal dominance, lower patient positive affect, and poorer ratings of interpersonal care; race and compliance stereotyping was associated with longer visits, slower speech, less patient centeredness, and poorer ratings of interpersonal care. Among White patients, bias was associated with more verbal dominance and better ratings of interpersonal care; race and compliance stereotyping was associated with less verbal dominance, shorter visits, faster speech, more patient centeredness, higher clinician positive affect, and lower ratings of some aspects of interpersonal care.
  
  
  CONCLUSIONS
  Clinician implicit race bias and race and compliance stereotyping are associated with markers of poor visit communication and poor ratings of care, particularly among Black patients.
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. lisa.cooper@jhmi.edu
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Cooper
authors.forename: Debra L
authors.initials: DL
authors.lastname: Roter
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Carson
authors.forename: Mary Catherine
authors.initials: MC
authors.lastname: Beach
authors.forename: Janice A
authors.initials: JA
authors.lastname: Sabin
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Greenwald
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Inui
mesh_terms: D000328:Adult; D001741:Black or African American; D001291:Attitude of Health Personnel; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011287:Prejudice; D011369:Professional-Patient Relations; D044469:Racial Groups; D016032:Randomized Controlled Trials as Topic; D012959:Socioeconomic Factors; D013240:Stereotyping; D014505:Urban Population