Dunn Lauren K, Pham Elizabeth, Kabil Emmad, Kleiman Amanda M, Hilton Ebony J, Lyons Genevieve R, Ma Jennie Z, Nemergut Edward C, Forkin Katherine T
Anesthesiology, University of Virginia School of Medicine, Charlottesville, USA.
Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, USA.
Cureus. 2023 Feb 8;15(2):e34778. doi: 10.7759/cureus.34778. eCollection 2023 Feb.
Background Biases affect patient perceptions of their physician and influence the physician-patient relationship. While racial disparities in care and inequities in the healthcare workforce are well-documented, the impact of physician race on patient perceptions remains unclear. We aimed to investigate the association of physician race and sex on patient perceptions during simulated preoperative encounters. Methods Three hundred patients recruited consecutively in the Preanesthesia Evaluation and Testing Center viewed pictures of 4 anesthesiologists (black male, white male, black female, white female) in random order while listening to a set of paired audio recordings describing general anesthesia. Participants ranked each anesthesiologist on confidence, intelligence, and likelihood of choosing the anesthesiologist to care for their family member, and chose the one anesthesiologist most like a leader. Results Compared to white anesthesiologists, black anesthesiologists had greater odds of being ranked more confident (OR, 1.45; 95% CI, 1.10 to 1.89; =0.008) and being considered a leader (OR, 2.06; 95% CI, 1.50 to 2.84; <0.0001). Among white participants, black anesthesiologists had greater odds of being ranked more intelligent (OR, 2.08; 95% CI, 1.54 to 2.81; <0.0001) and were more likely to be chosen to care for a family member (OR, 2.26; 95% CI, 1.66 to 3.08; <0.0001). Female anesthesiologists had greater odds of being ranked more intelligent (OR, 1.36; 95% CI, 1.08 to 1.71; =0.009) and were more likely to be chosen to care for a family member (OR, 1.58; 95% CI, 1.27 to 1.97; <0.001) compared with male anesthesiologists. Conclusions Contrary to our hypothesis, patients ranked black physicians more highly on multiple competence and leadership quality metrics. Our data likely highlight the role social desirability bias may play in studies of racial disparities within medicine.
背景 偏见会影响患者对其医生的看法，并影响医患关系。虽然医疗保健中的种族差异和医疗劳动力中的不平等现象有充分记录，但医生种族对患者看法的影响仍不明确。我们旨在研究在模拟术前会诊期间医生种族和性别与患者看法之间的关联。方法 在麻醉前评估和测试中心连续招募的300名患者，以随机顺序观看4名麻醉医生（黑人男性、白人男性、黑人女性、白人女性）的照片，同时收听一组描述全身麻醉的配对录音。参与者对每名麻醉医生在信心、智力以及选择该麻醉医生照顾其家庭成员的可能性方面进行排名，并选出最像领导者的一名麻醉医生。结果 与白人麻醉医生相比，黑人麻醉医生在被评为更有信心（比值比[OR]，1.45；95%置信区间[CI]，1.10至1.89；P = 0.008）以及被认为是领导者（OR，2.06；95% CI，1.50至2.84；P < 0.0001）方面的几率更高。在白人参与者中，黑人麻醉医生在被评为更聪明（OR，2.08；95% CI，1.54至2.81；P < 0.0001）以及更有可能被选择照顾家庭成员（OR，2.26；95% CI，1.66至3.08；P < 0.0001）方面的几率更高。与男性麻醉医生相比，女性麻醉医生在被评为更聪明（OR，1.36；95% CI，1.08至1.71；P = 0.009）以及更有可能被选择照顾家庭成员（OR，1.58；95% CI，1.27至1.97；P < 0.001）方面的几率更高。结论 与我们的假设相反，患者在多项能力和领导素质指标方面对黑人医生的排名更高。我们的数据可能凸显了社会期望偏差在医学种族差异研究中可能发挥的作用。
