The present study had three aims: 1) to evaluate if there are differences in treatment decisions among physicians for African American patients compared to White patients in a current sample of medical residents; 2) to evaluate if source of ...
eBook Title: Medical Treatment Decisions
Author:Neena Cassell
Published on 2015 by
A growing body of research has consistently demonstrated that treatment decisions for African American patients differ from that of similar White patients across various disease categories. Researchers have begun to focus on implicit bias as a reason for disparate treatment decisions. However, not all physicians are making seemingly discriminatory recommendations. This study has shifted the focus toward determining the impact of individual differences among physicians that may influence implicit bias, specifically their source of motivation to control prejudice (internal and external), which may ultimately impact treatment decisions. The synthesis of Self-determination theory and Ironic Process Theory provide a guiding framework for explaining the relation between internal and external motivations to control prejudice and implicit bias. The present study had three aims: 1) to evaluate if there are differences in treatment decisions among physicians for African American patients compared to White patients in a current sample of medical residents; 2) to evaluate if source of motivation (internal and external motivation to control prejudice) is related to the expression of implicit racial bias; and 3) to assess whether source of motivation to control prejudice and patient race interact with implicit bias to influence treatment decisions. A sample of 216 medical residents specializing in internal medicine, emergency medicine, and family/general medicine completed an online vignette in which they read the same description of a patient while being randomly assigned to see an African American patient or a White patient. They also completed various survey measures assessing internal motivation to control prejudice, external motivation to control prejudice, and implicit bias. Results of several regressions suggest that when controlling for implicit bias, as external motivation to control prejudice increases the odds of a decision to recommend thrombolysis for African American patients decreases. However, increases in internal motivation to control prejudice leads to an increase in the odds of a decision to recommend thrombolysis for African American patients. Overall, internal motivation to control prejudice in particular may help predict which physicians are best equipped to control implicit bias, likely resulting in nondiscriminatory treatment decisions despite racial profile of patients and external stresses. Understanding the factors that determine who is more or less effective at controlling bias might aid in the elimination of disparate treatment decisions.
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