title: Physicians' anxiety due to uncertainty and use of race in medical decision making.
abstract: BACKGROUND
  The explicit use of race in medical decision making is contested. Researchers have hypothesized that physicians use race in care when they are uncertain.
  
  
  OBJECTIVE
  The aim of this study was to investigate whether physician anxiety due to uncertainty (ADU) is associated with a higher propensity to use race in medical decision making.
  
  
  METHODS
  This study included a national cross-sectional survey of general internists.
  
  
  METHODS
  A national sample of 1738 clinically active general internists drawn from the SK&A physician database were included in the study.
  
  
  METHODS
  ADU is a 5-item measure of emotional reactions to clinical uncertainty. Bonham and Sellers Racial Attributes in Clinical Evaluation (RACE) scale includes 7 items that measure self-reported use of race in medical decision making. We used bivariate regression to test for associations between physician characteristics, ADU, and RACE. Multivariate linear regression was performed to test for associations between ADU and RACE while adjusting for potential confounders.
  
  
  RESULTS
  The mean score on ADU was 19.9 (SD=5.6). Mean score on RACE was 13.5 (SD=5.6). After adjusting for physician demographics, physicians with higher levels of ADU scored higher on RACE (+β=0.08 in RACE, P=0.04, for each 1-point increase in ADU), as did physicians who understood "race" to mean biological or genetic ancestral, rather than sociocultural, group. Physicians who graduated from a US medical school, completed fellowship, and had more white patients scored lower on RACE.
  
  
  CONCLUSIONS
  This study demonstrates positive associations between physicians' ADU, meanings attributed to race, and self-reported use of race in medical decision making. Future research should examine the potential impact of these associations on patient outcomes and health care disparities.
authors.affiliation: *Medica Research Institute, Minnetonka, MN †Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, MD ‡Department of Family Studies & Social Work, Miami University, Oxford, OH §Department of Medicine, Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
authors.forename: Brooke A
authors.initials: BA
authors.lastname: Cunningham
authors.forename: Vence L
authors.initials: VL
authors.lastname: Bonham
authors.forename: Sherrill L
authors.initials: SL
authors.lastname: Sellers
authors.forename: Hsin-Chieh
authors.initials: HC
authors.lastname: Yeh
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Cooper
mesh_terms: D000328:Adult; D000367:Age Factors; D001007:Anxiety / Q000209:etiology*; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D007388:Internal Medicine; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D044469:Racial Groups; D012737:Sex Factors; D035501:Uncertainty