Physician Racial Bias and Word Use during Racially Discordant Medical Interactions

ABSTRACT

Physician racial bias can negatively affect Black patients’ reactions to racially discordant medical interactions, suggesting that racial bias is manifested in physicians’ communication with their Black patients. However, little is known about how physician racial bias actually influences their communication during these interactions. This study investigated how non-Black physicians’ racial bias is related to their word use during medical interactions with Black patients. One hundred and seventeen video-recorded racially discordant medical interactions from a larger study were transcribed and analyzed using Linguistic Inquiry and Word Count (LIWC) software. Physicians with higher levels of implicit racial bias used first-person plural pronouns and anxiety-related words more frequently than physicians with lower levels of implicit bias. There was also a trend for physicians with higher levels of explicit racial bias to use first-person singular pronouns more frequently than physicians with lower levels of explicit bias. These findings suggest that non-Black physicians with higher levels of implicit racial bias may tend to use more words that reflect social dominance (i.e., first-person plural pronouns) and anxiety when interacting with Black patients.

Acknowledgments

This research was supported in part by an NINR grant (1R03NR013249-01) to the first author, an NICHD grant (1R21HD050445001A1) to the last author, and an NCI center grant (U01CA114583) to the Karmanos Cancer Institute/Wayne State University. This work has not been presented previously.