The Track Record of Implicit Bias and Medical Misdiagnosis

In medical care settings, does skin color contribute to the quality of medical care provided to patients, thus influencing their medical outcomes? Unfortunately, some analysis of this question has occurred in recent years favoring the notion that racial bias is a problem in the practice of medicine as in other professions. This conclusion made by many does not assert that the profession is filled with racist practitioners. It does, however, claim that disparities exist between men and women of color and white Americans when it comes to receiving proper medical care and treatment.

Diagnosis errors

We all know that doctors are not alone among the professions in making mistakes. In fact, millions of Americans receive a wrong diagnosis from a physician each year. According to David Newman-Toker, neurology professor at John Hopkins University, the top culprit causing these mistakes among doctors is bad judgment.

Several studies have been undertaken that utilize multiple vignettes that involve certain scenarios of patient care in addition to reactions to the Implicit Association Test, which was developed to help assess the presence of unconscious racial biases.

On July 11, a peer-reviewed paper was published in Diagnosis found that inaccurate diagnoses were identified in approximately 1/3 of medical malpractice claims in which the patient was either seriously disabled or died. In approximately 2/3 of those claims, the diagnosis error resulted in permanent disability or death. In addition, according to the study, claims resulting from diagnosis errors constituted 28% of insurance payouts.

David Newman-Toker, lead researcher of the study, stated that the research verifies past studies that indicate the scope of the problem.

Funded by the Society to Improve Diagnosis in Medicine, the study reviewed over 55,000 closed medical malpractice claims from 2006 to 2015 and found that almost 11,600 had allegations of diagnostic errors. Nearly 3/4 of those claims involved the conditions of vascular events such as heart attacks or strokes, cancer, and infections.

The study found that in hospital inpatient settings, the most common conditions cited in malpractice claims involved vascular issues. Cancer was the most often misdiagnosed condition in outpatient clinics.

Evidence of Implicit bias

In light of the Newman-Toker study and other studies focusing on implicit racial bias in health care, many believe implicit bias is influencing many instances of inaccurate medical diagnosis.

The results of other studies demonstrate distinct differences in the quality of healthcare provided to the races.

Nine separate studies published in Academic Emergency Medicine were reviewed in 2017. In most of these studies, the finding was that an implicit preference for white patients existed, principally by white doctors. A link between clinical decision-making and this type of bias was found in two of the studies.

Skin color should play no role in the quality of healthcare you receive from your doctor. Every physician and healthcare provider have legal and ethical responsibilities to provide treatment to every patient with the same standard of care. When a physician violates this duty and the patient suffers an injury or detrimental health consequences, or even death, the patient has a right to hold the hospital, medical facility, or doctor responsible in a medical malpractice lawsuit.

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