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In-hospital physicians may display racial bias with body language

Black patients receiving in-hospital end-of-life care often experienced fewer positive, rapport-building nonverbal cues from their physicians, compared with white patients, according to recently published data.

“Although we found that physicians said the same things to their black and white patients, communication is not just the spoken word. It also involves nonverbal cues, such as eye contact, body positioning and touch. Poor nonverbal communication — something the physician may not even be aware he or she is doing — could explain why many black patients perceive discrimination in the health care setting,” Amber Barnato, MD, MPH, associate professor of clinical and translational medicine, University of Pittsburgh School of Medicine, said in a press release.

Barnato and colleagues assessed the verbal emotion handling, shared decision-making behaviors and nonverbal behaviors of 22 hospital-based physicians when interacting with terminally ill white and black patients and their families to determine differences in the use of verbal and nonverbal communication. Analyzed behaviors included time interacting with the patient or family, posture, touching the patient and physical proximity to patient.

Results demonstrated that no differences were seen in physicians’ verbal communication between black and white patients.

Conversely, physicians had lower scores in nonverbal communication when interacting with black patients, compared with white patients, according to the researchers (P = .014).

The researchers noted that future research should focus on how racial biases may impact the quality of care and end-of-life decision-making among black patients and their families.

“When you survey people in the community about their feelings on end-of-life care, blacks are only slightly more likely than whites to say they want aggressive, life-sustaining measures when terminally ill. However, blacks are much more likely than whites to request such care when they are faced with making the decision in the hospital. Body language is a significant tool in building trust — or mistrust — and physicians need to ensure that their body language isn’t contributing to that decision in the hospital. To help black patients and their families feel welcome and encouraged to be partners in medical decision-making, it is critical that doctors be aware of their verbal and nonverbal communication and any unintentional biases,” Barnato said in the release.  – by Casey Hower

Disclosures: The researchers report no relevant financial disclosures.