title: Clinicians' implicit ethnic/racial bias and perceptions of care among Black and Latino patients.
abstract: OBJECTIVE
  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.
authors: Department of Psychology and Neuro-science, University of Colorado Boulder, 80309-0345, USA. Irene.Blair@Colorado.edu
authors: Irene V
authors: IV
authors: Blair
authors: John F
authors: JF
authors: Steiner
authors: Diane L
authors: DL
authors: Fairclough
authors: Rebecca
authors: R
authors: Hanratty
authors: David W
authors: DW
authors: Price
authors: Holen K
authors: HK
authors: Hirsh
authors: Leslie A
authors: LA
authors: Wright
authors: Michael
authors: M
authors: Bronsert
authors: Elhum
authors: E
authors: Karimkhani
authors: David J
authors: DJ
authors: Magid
authors: Edward P
authors: EP
authors: Havranek
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D003120:Colorado; D054521:Cultural Competency; D005260:Female; D019538:Health Care Surveys; D054625:Healthcare Disparities / Q000208:ethnology; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D017060:Patient Satisfaction / Q000208:ethnology* / Q000706:statistics & numerical data; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D058007:Physicians, Primary Care / Q000523:psychology*; D063505:Racism / Q000523:psychology*; D055815:Young Adult