Journal of General Internal Medicine

, Volume 24, Issue 1, pp 137–140 | Cite as

Implicit Bias Among Physicians

  • Neal V. Dawson
  • Hal R. ArkesEmail author
Letter to the Editor

To the Editor: Green and colleagues1 claim to have provided evidence that unconscious (implicit) race bias among physicians is causally associated with fewer recommendations for appropriate thrombolytic treatment for African-American male patients who present with symptoms suggestive of acute coronary syndromes. We attempt to demonstrate why this claim is not substantiated.

From a sample of 776 internal medicine and ED residents, Green and colleagues obtained data from 220 who were unaware of the purpose of the study or who were not otherwise excluded. They were shown a vignette about a 50-year-old man with a history of hypertension and smoking who presented to the ED with chest pain. With the vignette the face of a white or black man of approximately age 50 was randomly paired. The vignette was written to be consistent with the presentation of myocardial infarction, in particular containing an EKG reading that was “suggestive of anterior myocardial infarction.” The subject was told...


Aortic Aneurysm Aortic Dissection Pericarditis Implicit Association Test Implicit Association 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We are grateful to Dana R. Carney for providing us with the four data points from Figure 3d in Green et al.

Conflict of Interest

None disclosed.


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Copyright information

© Society of General Internal Medicine 2008

Authors and Affiliations

  1. 1.General Internal Medicine, Center for Health Care Research & PolicyCase Western Reserve University at MetroHealth Medical CenterClevelandUSA
  2. 2.Department of PsychologyOhio State UniversityColumbusUSA

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