Are Doctors Biased Against Patients?

Are Doctors Biased Against Patients? And if so, does it affect the treatment they provide.

A survey from Medscape asked this question. The short answer, Yes. They are. I didn’t need a survey to tell me that. However, it is interesting to see the many ways that doctors are biased against patients.

I shared a study a while back that showed that many doctors are biased against patients with Fibromyalgia. Biased might not be the right word there, as what it really came down to was that many doctors are just plain scared to treat us, or simply they don’t want to treat us because they don’t feel they can help us. I can understand that. No one wants to continue to fight what they feel is a losing battle. If I were a doctor that didn’t have any good answers for fibromyalgia (or any illness) I’d refer those patients out to someone who I hoped had better answers.

But, the story in this survey seems to be a bit different.

Almost 16,000 doctors filled out the survey from Medscape, which examined two factors: bias and burnout. The interesting finding reguarding burnout is that rheumatologists (the specialists that most commonly treat fibromyalgia), along with psychologists reported the lowest levels of burnout. That’s good news for us. I guess that means that those doctors who have chosen to deal with us are dealing well with their role.

When asked about the causes of their burnout, bureaucracy (in many forms) lead the pack, sadly followed by “too many difficult patients”. A frequent comment had to do with lack of patient appreciation and respect (I do hope they know it’s a two-way street). Are we those difficult patients? What is a difficult patient? And, what can we do about it? Those are questions for another day.

On to the biases:

• 40% of the doctors surveyed admitted to having some sort of bias towards specific groups of patients.
• The more that a specialty had direct interaction with patients the more likely they were to report a bias.
• Because this study was based on direct reports from the doctors it only reports conscious biases, so there may be unconscious (or implicit) biases that also affect their interactions.

Only 16% of the doctors in this survey reported that their biases affected the treatment they give. I have a feeling this is likely where the doctors weren’t being completely honest. It’s one thing to admit to a bias, it’s another thing to admit that it actually affects the level of care that you give. Interestingly, of the doctors who reported that their bias affects treatment, 25% said that they actually give better treatment to those who they are biased against because they overcompensate for their bias.

ER doctors were most likely to admit that bias affects the treatment they give. If you’ve ever been to the ER you’ve probably encountered this bias… and I doubt you’d say it had a positive outcome.

Top Causes of Doctor Bias

Language differences were the top reported cause of bias. What’s really interesting here is that the doctors who were most likely to report bias negatively affecting their treatment were doctors who identified as Asian.

Emotional Problems came in second. If this isn’t a reminder to keep your emotions in check at the doctor’s office I don’t know what is. If there’s ever a time to make sure you don’t cry it’s when you are facing a doctor. I’ve broken down in a doctor’s office a time or two and I can honestly say that doing so really let me know who that doctor was. The sad part is that many doctors do view any break as an emotional problem. It doesn’t matter how much pain we are in, to many of the doctors we are weak if we can’t keep our emotions in check.

Heavier weight was a very close third. I find this humorous given the number of medical professionals I’ve met who are grossly overweight. Perhaps it’s only the fit ones that judge their patients based on weight, but I doubt it. More male doctors than females reported this as a bias. At least they are aware, but you’d think that as doctors they’d also be aware that it’s not always within the patient’s control.

Doctors were most likely to report that these two biases resulted in a negative treatment.

Which doctors are more likely to be biased?

• Younger doctors (under 45) were less likely to report that their bias resulted in negative treatment, saying that they were more likely to overcompensate.
• Older doctors were much likely to report that their bias resulted in negative treatment.
• Doctors who describe themselves as politically “socially liberal” are more likely to report bias than those who describe themselves as “socially conservative.”
• Doctors who were born in the US report greater levels of bias than those who came to the US as adults, with those who came to the US as children falling in the middle.

Overall, this was an interesting survey. It’s worth taking a look at the full survey results as there were a few other (unrelated) questions that I didn’t cover, including questions about marijuana use and prescribing habits.

Another thing that I found missing from this survey, and I don’t know if it was because they didn’t ask or because the doctors didn’t respond was a bias against patients using opioid medication, or a bias against pain patients in general. This is a bias that many of us have encountered and one that is often discussed, yet there was no mention of it here.

Have you encountered a doctor who was biased against you for some reason? Do you know what their bias was? Or, do you think you know?

Related Posts:

• Talking With Your Doctor About Pain
• Women: Often “Miss Treated” By Doctors
• Why are Doctors Reluctant to Treat Fibromyalgia Patients
• Dismissive Doctors and the Death of Compassion for Invisible Illness