Implicit Bias Against BIPOC Patients in Clinical Settings: A Qualitative Review

Abstract

Black, Indigenous, and People of Color (BIPOC) from stigmatized and marginalized communities face implicit bias in medicine. Implicit biases are unconscious attitudes and internalized discrimination developed through repeated practices based on stereotypes from a foundation of systematic racism. In clinical settings, it impacts individuals’ healthcare experience and treatment outcomes. This study aimed to characterize and address implicit bias among healthcare providers toward BIPOC patients in clinical settings. A literature search in MEDLINE/PubMed, CINAHL, PsyArticles, PsycINFO from EBSCO databases was conducted to include all peer-reviewed studies (2012-2021) about implicit bias toward BIPOC. Most healthcare providers have some form of implicit bias-positive attitudes toward Whites and negative attitudes toward BIPOC which affects treatment decisions and overall quality of care they receive. BIPOC patients are likely to be prescribed a lower dosage of medication instead of opioid analgesics for both acute and chronic pain despite age, gender, or genetic factors. Structural and social factors that impact access to healthcare include the patient's sociodemographic variables such as age, gender, economic/employment stability, access to higher education, and geographic access to healthcare facilities. Future studies need to employ rigorous methods to examine the relationship between implicit bias and healthcare outcomes. Interventions targeting implicit attitudes among health care professionals are needed to reduce health disparities and improve the overall clinical care of BIPOC patients. Educational initiatives, reformed policies/practices, and new research are needed. Acknowledging racial/ethnic, and cultural bias in clinical settings minimizes implicit bias and reduces negative health care experiences for BIPOC.