Bias and Burnout: Evil Twins

Carol Peckham

Disclosures

January 12, 2016

In This Article

What Physician Factors Contribute to Physician Bias?

The survey looked at certain physician lifestyle and demographic factors (burnout, age, location, religion, political leaning) in relationship to bias. Some associations were observed, but it would be difficult to draw conclusions from them.

Age and bias. When looking at age groups, the percentages of physicians who admitted biases steadily decreased with age (Figure 7).

Figure 7.

Bias, by Age

Nevertheless, when looking at the effects of physician age on patient treatment among physicians who admit such effects, negative treatment (less time, less friendly) increases with age as positive treatment decreases (more time, more friendly) (Figure 8). Over one half of physicians older than 46 years reported that biases affect treatment negatively, compared with less than one half saying that they result in overcompensation and giving patients special treatment. Among those aged 45 years or younger, the reverse holds: Over one half report that their biases result in more positive treatment, compared with fewer whose biases result in negative approaches.

Figure 8. Bias Effects on Treatment, by Age

Location and bias. The greatest percentage of physicians who said they were biased live in the Northwest (49%) and the West and Southwest (both 43%). The East Coast harbors those who expressed the lowest bias levels: Northeast, Mid-Atlantic, and Southeast (all 37%). In general, the longer a physician lives in the United States, the more likely he or she is to develop bias. Only 27% of those who came to the United States as adults said they were biased, compared with 38% who have lived here since childhood and 43% of those who were born in this country.

Spirituality and bias. Some research suggests that religious fundamentalism is linked with prejudice toward a wide variety of minorities.[28] The Medscape survey, however, found little relationship between spiritual belief and bias. Similar percentages of physicians who said they had a spiritual belief or had none also said they had no biases toward patients (61% and 58%, respectively).

Political leaning and bias. It is of some interest that regardless of whether they describe themselves as fiscally conservative or liberal, physicians who defined themselves as socially liberal had higher percentages of bias (43% and 42%, respectively) than physicians who said they were socially conservative (38% and 35%). Of note, a 2013 analysis examining implicit bias toward black persons found a higher rate among conservatives than liberals. Study participants were shown a series of faces that were morphed from 100% black to 100% white. Participants who self-reported as conservatives were more likely to categorize faces that were racially ambiguous as black.[29] However, the argument on whether conservatives or liberals are more or less biased is itself fraught with bias.

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