Implicit Stereotyping and Medical Decisions: Unconscious Stereotype Activation in Practitioners' Thoughts About African Americans

Objectives. We investigated whether stereotypes unconsciously influence the thinking and behavior of physicians, as they have been shown to do in other professional settings, such as among law enforcement personnel and teachers. Methods. We conducted 2 studies to examine whether stereotypes are implicitly activated in physicians. Study 1 assessed what diseases and treatments doctors associate with African Americans. Study 2 presented these (and control terms) to doctors as part of a computerized task. Subliminal images of African American and White men appeared prior to each word, and reaction times to words were recorded. Results. When primed with an African American face, doctors reacted more quickly for stereotypical diseases, indicating an implicit association of certain diseases with African Americans. These comprised not only diseases African Americans are genetically predisposed to, but also conditions and social behaviors with no biological association (e.g., obesity, drug abuse). Conclusions. We found implicit stereotyping among physicians; faces they never consciously saw altered performance. This suggests that diagnoses and treatment of African American patients may be biased, even in the absence of the practitioner's intent or awareness. (Am J Public Health. 2012;102:996-1001. doi:10.2105/AJPH.2011.300591)