The associations of clinicians' implicit attitudes about race with medical visit communication and patient ratings of interpersonal care

Lisa A. Cooper, Debra L. Roter, Kathryn A. Carson, Mary Catherine Beach, Janice A. Sabin, Anthony G. Greenwald, Thomas S. Inui

Research output: Contribution to journalArticle

307 Scopus citations

Abstract

Objectives. 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.

Original languageEnglish (US)
Pages (from-to)979-987
Number of pages9
JournalAmerican journal of public health
Volume102
Issue number5
DOIs
StatePublished - May 1 2012

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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