Physicians' Unconscious Racial Bias Could Impair Health Outcomes

To make her point, Cooper, who is African-American, says she took the IAT and it showed that she had a slight bias against African-American patients.

"I grew up in Africa and spent time in Europe before I came to the United States. I thought of myself as so multicultural. I have lived with so many different people. Surely I wouldn't have any unconscious biases," she says. "I found out of my test I had a slight preference for whites over blacks."

Cooper says she was surprised at the extent to which the patients sensed the bias in the study. "When there was more bias, particular the African-African patients talked of feeling less respected, not as well liked and felt like they didn't trust the doctor as much. Even though this was not overt, there was something patients could pick up on."

Cooper recommends that physicians take the IAT to learn if they may be harboring unconscious biases. The test is free and confidential and can be done online. If the test determines that a bias exists, Cooper says that does not make the physician a racist or a bad person, only human.

"Our experience has been that when physicians are made aware that something they are doing is not resulting in a good impression with a patient they are more than willing to try something different," she says.

"You don't say 'I can't appear racist' because when you do that you raise the patient's anxiety level so they behave more poorly," she says. "We focus on the positive. 'What is the best way I can behave in this interaction to make sure this person knows I value his opinion?'"

To confront her own biases, Cooper says she does a quick self-assessment before meeting with patients.

"I question myself before I move forward in my interaction," she says. "What assumptions am I making about this person where I could be wrong? Just doing that is an excellent first step. Have people make sure they stop and question their assumptions and ask themselves 'Am I behaving any differently than I would if this person appeared to be different?'"

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