Do Bú Emerson, Eggly Susan, Penner Louis, Hagiwara Nao
Institute of Social Sciences, University of Lisbon, Lisbon, Portugal; Department of Psychology, ISCTE - University Institute of Lisbon, Lisbon, Portugal.
Department of Oncology, Wayne State University/Karmanos Cancer Institute, Detroit, MI, USA.
Patient Educ Couns. 2025 May;134:108653. doi: 10.1016/j.pec.2025.108653. Epub 2025 Jan 10.
To investigate the relationship between non-Black physicians' racial attitudes, Black patients' discrimination experiences, and consultation duration in diverse clinical settings.
Secondary analyses were conducted on data from three prior studies involving non-Black primary care physicians (Study 1: n = 14, Study 2: n = 5) and their Black patients (Study 1: n = 118, Study 2: n = 31), as well as 15 non-Black oncologists and their 72 Black patients (Study 3). Data included physician and patient surveys, along with video-recorded consultations.
Study 1 revealed that, relative to other physicians, physicians whose racial attitudes fit an aversive racist profile (i.e., low explicit racial bias, high implicit bias) had longer consultations with Black patients who reported more (vs. fewer) discrimination experiences. Study 2 and 3 found that physicians' implicit racial bias is negatively associated with consultation duration. Finally, a meta-analysis supported the effects of aversive racism and patients' discrimination experiences on consultation duration.
These findings demonstrate how physicians' racial attitudes and patients' discrimination experiences can affect medical consultation duration-an important aspect of patient-provider communication quality.
These results provide initial evidence for the importance of helping physicians manage the negative consequences of their implicit bias within the current structural constraints of limited medical consultation time and empowering Black patients to advocate for their healthcare needs.
探讨在不同临床环境中，非黑人医生的种族态度、黑人患者的歧视经历与诊疗时长之间的关系。
对来自之前三项研究的数据进行二次分析，这三项研究涉及非黑人初级保健医生（研究1：n = 14，研究2：n = 5）及其黑人患者（研究1：n = 118，研究2：n = 31），以及15名非黑人肿瘤学家及其72名黑人患者（研究3）。数据包括医生和患者的调查问卷以及视频记录的诊疗过程。
研究1显示，与其他医生相比，种族态度符合厌恶性种族主义特征（即显性种族偏见低、隐性偏见高）的医生，与报告更多（而非更少）歧视经历的黑人患者诊疗时间更长。研究2和3发现，医生的隐性种族偏见与诊疗时长呈负相关。最后，一项荟萃分析支持了厌恶性种族主义和患者的歧视经历对诊疗时长的影响。
这些发现表明了医生的种族态度和患者的歧视经历如何影响医疗诊疗时长，而诊疗时长是医患沟通质量的一个重要方面。
这些结果为以下两点的重要性提供了初步证据：一是在当前医疗诊疗时间有限的结构限制内，帮助医生管理其隐性偏见的负面影响；二是使黑人患者能够为自己的医疗需求发声。
