Investigating the Relationship between Resident Physician Implicit Bias and Language Use during a Clinical Encounter with Hispanic Patients

ABSTRACT

Prior research suggests that the implicit biases of physicians are negatively associated with quality of medical care and patient satisfaction among minority patients. However, relatively little is known about how physicians express these subtle forms of bias in patient interactions. This study examined the implicit and explicit anti-Hispanic biases of 53 resident physicians and the relationship between anti-Hispanic bias and language use during outpatient medical appointments with 291 Hispanic patients. Physician implicit bias was positively associated with use of interrogatives and work-related words and negatively associated with the use of prepositions and relativity-related words (e.g., words related to time and the future). These findings contribute to the growing body of evidence suggesting that, in addition to nonverbal and paraverbal behaviors, providers may communicate implicit bias to patients through the words they use during a clinical visit.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. This research was submitted for ethics review and approved by the University of Arizona Institutional Review board, protocol number 1406364892A010.

2. Although the NIH term for this ethnic group is “Hispanic or Latino”, we choose to use the gender-neutral term Hispanic as it is seen as more inclusive.

3. Two other measures, measures of patient satisfaction and resident perceptions of the appointment, are discussed in another manuscript (Wolsiefer et al., 2021) and are thus not reported here. We include this footnote for transparency.

Additional information

Funding

This work was supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Grant [#5R01MD008940-05].