Department of Business Administration, University of Zurich, Zurich, Switzerland 8006.
Department of Psychology, Antioch University, Seattle, WA 98121.
Proc Natl Acad Sci U S A. 2022 Jul 5;119(27):e2007717119. doi: 10.1073/pnas.2007717119. Epub 2022 Jun 27.
The healthcare workforce in the United States is becoming increasingly diverse, gradually shifting society away from the historical overrepresentation of White men among physicians. However, given the long-standing underrepresentation of people of color and women in the medical field, patients may still associate the concept of doctors with White men and may be physiologically less responsive to treatment administered by providers from other backgrounds. To investigate this, we varied the race and gender of the provider from which White patients received identical treatment for allergic reactions and measured patients' improvement in response to this treatment, thus isolating how a provider's demographic characteristics shape physical responses to healthcare. A total of 187 White patients experiencing a laboratory-induced allergic reaction interacted with a healthcare provider who applied a treatment cream and told them it would relieve their allergic reaction. Unbeknownst to the patients, the cream was inert (an unscented lotion) and interactions were completely standardized except for the provider's race and gender. Patients were randomly assigned to interact with a provider who was a man or a woman and Asian, Black, or White. A fully blinded research assistant measured the change in the size of patients' allergic reaction after cream administration. Results indicated that White patients showed a weaker response to the standardized treatment over time when it was administered by women or Black providers. We explore several potential explanations for these varied physiological treatment responses and discuss the implications of problematic race and gender dynamics that can endure "under the skin," even for those who aim to be bias free.
美国的医疗保健劳动力正变得越来越多样化,逐渐改变了社会中医生群体以白人男性为主的历史局面。然而,鉴于有色人种和女性在医疗领域长期以来代表性不足的情况,患者可能仍然将医生的概念与白人男性联系在一起,并且可能对来自其他背景的医护人员的治疗反应生理上不太敏感。为了研究这一点,我们改变了接受相同过敏反应治疗的白人患者的医生种族和性别,并测量了患者对这种治疗的反应改善情况,从而孤立出医生的人口统计学特征如何影响他们对医疗保健的身体反应。共有 187 名经历实验室诱导过敏反应的白人患者与一名医疗保健提供者互动,该提供者涂抹了一种治疗乳膏,并告诉他们这将缓解他们的过敏反应。患者并不知道乳膏是无活性的(无味乳液),除了提供者的种族和性别外,所有互动都是完全标准化的。患者被随机分配与男性或女性以及亚洲人、黑人或白人的提供者进行互动。一名完全盲目的研究助理测量了乳膏给药后患者过敏反应大小的变化。结果表明,当由女性或黑人医护人员提供标准化治疗时,白人患者的反应随着时间的推移会变弱。我们探讨了这些不同的生理治疗反应的几种潜在解释,并讨论了即使对于那些试图消除偏见的人来说,可能会持续存在的有问题的种族和性别动态的影响。