Implicit Racial Bias in Physicians: Racial Disparity in Opioid Prescriptions in United States Emergency Departments

Over the past 30 years, a documented racial disparity in opioid prescriptions in U.S. emergency care departments has persisted despite overall prescription trends fluctuating throughout the rise and fall of the early 2000’s opioid epidemic. Consistently, Blacks and other minorities receive lower levels of opioid analgesics when presenting with conditions or characterizing pain levels similar to white patients. This study focuses on identifying the mechanisms of implicit racial bias, quantified by scores on the Implicit Bias Association Test (IAT), that influences physicians’ abilities to equitably assess and treat pain of racially diverse patient populations. Research has shown that physicians with higher IAT scores, indicating a stronger preference for Caucasian faces, displayed bias in their ability to empathize with races outside of their own. Physicians with higher IAT scores may lack the ability to effectively empathize with black patient’s pain, thus resulting in the under-prescription of opioid analgesics for black patients. Although subconscious stereotyping is a natural byproduct of the brain’s categorization process, implicit bias is reducible if physicians make conscious efforts. Medical schools should integrate implicit bias training protocols utilizing social cognitive psychology theories, such as individuation exercises, and intermittent, anonymous IAT testing into the medical education process in order to reduce implicit racial bias amongst practicing physicians