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Patient Perceptions of Physician Education and Quality by Race

P

President and Fellows of Harvard College

Status

Completed

Conditions

Bias, Racial
Racism

Treatments

Behavioral: Exposure to a Photo

Study type

Interventional

Funder types

Other

Identifiers

NCT04940234
IRB21-0682

Details and patient eligibility

About

Research has documented positive effects of doctor-patient race concordance, suggesting that increasing diversity among healthcare professionals may play an important role in addressing well-documented racial health disparities in the US. It also remains critical to improve the quality of interactions in race discordant doctor-patient relationships. However, as health systems consider policies to increase the number of minority healthcare professionals, especially among doctors, questions about the equilibrium effects of such initiatives naturally emerge. In this project, the investigators examine whether and how patients vary their perceptions of healthcare professionals by race.

Full description

Research has documented positive effects of doctor-patient race concordance. Given the low representation of minorities among doctors in the US, this evidence suggests that the path to addressing well-documented racial health disparities involves both increasing diversity among healthcare professionals and improving the quality of interactions in race-discordant doctor-patient relationships. Increased focus on improving minority representation among healthcare professionals, and especially among doctors, naturally raises questions about the equilibrium effects of such initiatives. In this study, the investigators aim to explore one potential avenue for equilibrium effects. A growing literature examines how doctors' behavior and beliefs change with patient race and potentially affect the quality of healthcare interactions. This project examines whether and how patients vary their perceptions of the quality of doctors based on race. Significant variation in the perceived quality of minority healthcare professionals could adversely affect the quality and effectiveness of healthcare interactions involving these professionals. Moreover, the range of potential negative patient attitudes that could be encountered in day-to-day clinical practice may also be considered an anticipatory tax and another barrier for prospective minority trainees.

This projects aim to test the following hypotheses: (1) whether subjects believe Black experts are less educated compared with White experts; (2) whether subject believe Black experts are lower quality compared with White experts; (3) whether there is any variation in these two outcomes based on respondent race. The investigators also explore a potential mechanism by examining the extent to which differences in patients' beliefs about the likely occupation of individuals explains differences in patients' beliefs about educational attainment and quality. In this case, the investigators hypothesize that the race of the individual in the photo may be affecting the weight that individuals put on the "expert attire" treatment.

Enrollment

1,500 patients

Sex

All

Ages

25+ years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

  • participant identifies as Black or White

Exclusion criteria

  • participant doesn't identify as Black or White
  • younger than 25 years old

Trial design

Primary purpose

Health Services Research

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Single Blind

1,500 participants in 4 patient groups

Black Expert
Experimental group
Description:
Survey respondents are exposed to a Black person wearing expert attire.
Treatment:
Behavioral: Exposure to a Photo
Black Layperson
Experimental group
Description:
Survey respondents are exposed to a Black person wearing layperson's attire.
Treatment:
Behavioral: Exposure to a Photo
White Expert
Experimental group
Description:
Survey respondents are exposed to a white person wearing expert attire.
Treatment:
Behavioral: Exposure to a Photo
White Layperson
Experimental group
Description:
Survey respondents are exposed to a white person wearing layperson's attire.
Treatment:
Behavioral: Exposure to a Photo

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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