Racial disparities in clinician responses to patient emotions.
Jenny Park, Mary Catherine Beach, Dingfen Han and 3 others
PMID 32253063WHAT IT FOUND
In HIV visits, clinicians were more likely to block emotional talk from African American patients and less likely to give them space to continue.
White patients were more likely to raise emotions spontaneously and receive passive responses.
Key findings
01Clinicians were more likely to block emotional conversation with African American patients than with other patients (odds ratio 2.20), and less likely to give neutral or passive responses that let them continue (odds ratio 0.56).
02African American patients had more than three times greater odds of expressing emotion by repeating an otherwise neutral statement (odds ratio 3.40) and were more likely than other patients to have emotions elicited by the provider rather than spontaneously express them (odds ratio 1.99).
03Patient age and gender were not associated with emotional expressions or clinician responses, and clinician race was not associated with either.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was observational and cross-sectional, so it cannot show that clinician responses caused any outcome. Audio recordings only were analyzed, so nonverbal emotional cues and responses could have been missed. Many outcomes were examined, so some significant differences may have occurred by chance. It was conducted in HIV care at two urban academic centers, so it may not apply to other settings or patient groups. There were too few non-white clinicians to examine clinician race or patient-clinician concordance. Actual duration of patient-clinician relationships was not measured, only that patients had been in care for more than six months.
Declared interests
The supplied text lists NIH extramural research support. No author conflict-of-interest declaration is given.
The easy way to misread this
Do not conclude that these patterns prove individual clinician bias or that they caused worse HIV outcomes. The study is observational, limited to HIV visits, and did not measure causes or patient outcomes.