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63 pages 2 hours read

Dayna Bowen Matthew

Just Medicine: A Cure for Racial Inequality in American Health Care

Nonfiction | Book | Adult | Published in 2015

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Chapters 5-7Chapter Summaries & Analyses

Chapter 5 Summary: “Implicit Bias during the Clinical Encounter”

The first section of Chapter 5, titled “Mechanism 3: Physicians’ Implicit Biases Influence Their Conduct and Communication.” Under the third mechanism of the Biased Care Model, Matthew explains how physicians’ unconscious racial biases negatively influence their verbal and nonverbal communication with patients. Medical students, closely observing clinical interactions, notice how doctors often change their tone, body language, and engagement when dealing with BIPOC patients. These shifts, including spending less time with BIPOC patients, result from systemic pressures and routines that cause physicians to fall back on implicit bias.

Matthew discusses research showing that white physicians often display anxiety and hostility when interacting with BIPOC patients, which lowers the quality of care they provide. Studies, such as those carried out by Dr. Elizabeth Hooper and Dr. Rachel Johnson, reveal that physicians use a more pre-determined style of questioning, demonstrate less empathy, and are more verbally dominant with BIPOC patients compared to whites. These communication disparities result in less patient-centered care for marginalized populations.

Matthew also explores how BIPOC patients often receive less information from physicians due to unconscious bias. Doctors may assume BIPOC patients cannot afford care or comprehend complex treatments, which leads to poorer communication.

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