Evaluating sources and implications of doctor bias

摘要

In recent years, a great deal of attention has been directed to the importance of doctor decision-making as a potential source of bias in clinical care and contributor to medical practice variation. This shift towards looking inward to health care delivery as a source of disparities, rather than outward towards patients and their families, is a major change in perspective from earlier decades in which differential patient ‘non-compliance’ and utilisation were treated as linchpins in understanding variant health outcomes. Although a productive change, this shift in research has also generated mixed results and, in places, led to growing literatures that are not clearly integrated and as a result have conflicted implications for medical education. In Nazione and Silk's article,[1] we see an important contribution in this direction that helps bridge some of these gaps by considering how doctor bias about race interacts with perceptions of patient responsibility and doctors’ willingness to help. A challenge for medical education and health policy researchers alike is how to integrate this body of knowledge and apply it to medical work in ways that minimise biases exacerbating disparities while also maximising efficiency and accuracy in medical care.