Findings show gender and race may not affect patient satisfaction scores, but doesn’t detract from negative lived experiences for minority groups.
Bias and prejudice may not be as big a factor in patient perceptions of care as previously thought, with new data showing that patients would rate a female surgeon, or a surgeon of a minority race the same as a white male doctor.
The data, published in JAMA Network Open, used simulated patient experiences to assess whether female doctors or doctors who are black would face difficulties obtaining a good patient satisfaction score compared to a control doctor, who was white and male.
The country is a conglomeration of multiple races and ethnicities, and the medical professional field is increasingly reflecting that, the researchers said. But with this diversifying field comes questions about patient bias and prejudice.
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Reports of workplace bias from peers and discrimination from patients have upset female and minority groups has they practice in the medical field. Conflicting data outlines patient preferences for certain genders for their physicians or instances of racism in the medical facility.
However, whether these are upsetting, isolated incidents or evidence of a broader trend of discrimination in healthcare remains to be seen, the researchers said.
Using simulated patient experiences, the researchers sought to understand whether implicit or explicit bias would color patient satisfaction scores.
Just over 3,500 adult patients were randomly assigned to either a white male physician, a while female physician, a black female physician, or a black male physician. Patients were then run through simulated healthcare experiences that was intended to elicit different responses along the overall sample encounter.
Once the simulation was complete, patients awarded their providers a composite score on a 100-point scale. Scores were based on patients’ confidence in their physicians, satisfaction with care, likelihood to recommend the physician, and likelihood to request additional tests.
On the whole, a physician’s ethnicity or gender did not matter when patients scored their experiences. The researchers observed negligible difference in patient satisfaction and confidence scores between the white male control physician and the other physicians included in the simulated experiences.
The while male physician received a 66.13 on the 100-point patient experience scale, while white female physicians received a 66.50, black female physicians received a 67.36, and black male physicians received a 66.96. These findings indicate that patients do not harbor explicit bias against female or minority providers that would impact satisfaction scores.
However, the researchers did assert that these findings do not detract from the real and often damaging racist or discriminating encounters providers have experienced.
“Of importance, the results reported here should not be interpreted as contradicting the lived experiences of discrimination reported by physicians from underrepresented groups,” the researchers emphasized. “The absence of a systematic preference for white male physicians in the controlled setting does not diminish the damaging and lasting effect that even a single instance of discrimination from patients or colleagues can have on minority and female physicians.”
Further, the researchers pointed out a few limitations to their study that could have led to their current results. Primarily, the notion that participants may have guessed the purpose of the simulation test could have swayed outcomes.
“It is theoretically possible that some participants may have discerned the purpose of the study and censored their prejudice against female and black physicians to appear more socially desirable, thereby attenuating estimated treatment effects,” the research team said. “However, all participants were blinded to the study objectives, and to our knowledge, there is no empirical support for such threats to inference in randomized survey experiments conducted in the anonymous online environment.”
The fact that the simulations were just that – simulated, unreal encounters – could have also swayed patient responses, the team said.
Nonetheless, these results give a glimpse into the role that bias and discrimination may play in patient-provider relationships. Findings that a physician’s race or gender will play a limited role in perceived patient experience suggests that other factors could be a play in the physician workplace experience.
“The importance of creating inclusive and diverse workplaces in health care cannot be overstated because more diverse teams are associated with better patient care, lower mortality, better science, and more successful organizations with higher productivity, innovation, and employee retention,” the researchers concluded.
“Thus, there is a renewed call to improve the status quo through institutional-level change to elevate underrepresented groups using accountability measures through organizations such as Time’s Up Healthcare and Men Advocating Real Change. Our study further supports these efforts by suggesting that patient bias against physicians may be less of a driver of workplace discrimination than these other sources.”
Source: patient Engagement Hit