RT Journal Article SR Electronic T1 Clinicians’ Implicit Ethnic/Racial Bias and Perceptions of Care Among Black and Latino Patients JF The Annals of Family Medicine JO Ann Fam Med FD American Academy of Family Physicians SP 43 OP 52 DO 10.1370/afm.1442 VO 11 IS 1 A1 Irene V. Blair A1 John F. Steiner A1 Diane L. Fairclough A1 Rebecca Hanratty A1 David W. Price A1 Holen K. Hirsh A1 Leslie A. Wright A1 Michael Bronsert A1 Elhum Karimkhani A1 David J. Magid A1 Edward P. Havranek YR 2013 UL http://www.annfammed.org/content/11/1/43.abstract AB PURPOSE We investigated whether clinicians’ explicit and implicit ethnic/racial bias is related to black and Latino patients’ perceptions of their care in established clinical relationships. METHODS We administered a telephone survey to 2,908 patients, stratified by ethnicity/race, and randomly selected from the patient panels of 134 clinicians who had previously completed tests of explicit and implicit ethnic/racial bias. Patients completed the Primary Care Assessment Survey, which addressed their clinicians’ interpersonal treatment, communication, trust, and contextual knowledge. We created a composite measure of patient-centered care from the 4 subscales. RESULTS Levels of explicit bias were low among clinicians and unrelated to patients’ perceptions. Levels of implicit bias varied among clinicians, and those with greater implicit bias were rated lower in patient-centered care by their black patients as compared with a reference group of white patients (P = .04). Latino patients gave the clinicians lower ratings than did other groups (P <.0001), and this did not depend on the clinicians’ implicit bias (P = .98). CONCLUSIONS This is among the first studies to investigate clinicians’ implicit bias and communication processes in ongoing clinical relationships. Our findings suggest that clinicians’ implicit bias may jeopardize their clinical relationships with black patients, which could have negative effects on other care processes. As such, this finding supports the Institute of Medicine’s suggestion that clinician bias may contribute to health disparities. Latinos’ overall greater concerns about their clinicians appear to be based on aspects of care other than clinician bias.