“The doctor will see you now… but not for long”: Linking physicians’ racial attitudes and patients’ discrimination experiences to racial disparities in the duration of medical consultations

Abstract

Objective

To investigate the relationship between non-Black physicians’ racial attitudes, Black patients’ discrimination experiences, and consultation duration in diverse clinical settings.

Methods

Secondary analyses were conducted on data from three prior studies involving non-Black primary care physicians (Study 1: n = 14, Study 2: n = 5) and their Black patients (Study 1: n = 118, Study 2: n = 31), as well as 15 non-Black oncologists and their 72 Black patients (Study 3). Data included physician and patient surveys, along with video-recorded consultations.

Results

Study 1 revealed that, relative to other physicians, physicians whose racial attitudes fit an aversive racist profile (i.e., low explicit racial bias, high implicit bias) had longer consultations with Black patients who reported more (vs. fewer) discrimination experiences. Study 2 and 3 found that physicians’ implicit racial bias is negatively associated with consultation duration. Finally, a meta-analysis supported the effects of aversive racism and patients’ discrimination experiences on consultation duration.

Discussion

These findings demonstrate how physicians’ racial attitudes and patients’ discrimination experiences can affect medical consultation duration—an important aspect of patient-provider communication quality.

Practical value

These results provide initial evidence for the importance of helping physicians manage the negative consequences of their implicit bias within the current structural constraints of limited medical consultation time and empowering Black patients to advocate for their healthcare needs.