Last update:
17-Jul-2014

Several types of methodological design have been used to assess the influence of stereotypes among doctors on various aspects of healthcare delivery. This review highlights the key findings and the shortcomings of the different methodological designs used to assess the impact of stereotypes on healthcare delivery, with an emphasis on medical decision-making. It is argued that while prospective, retrospective, and experimental methods of assessment have progressively established a valid and reliable link between stereotyping and healthcare outcomes, the methodology did not assess directly the presence of stereotypes, but assumed their existence from the differences in socio-demographic characteristics. Stereotypes, however, concern socially sensitive, implicit cognitive bias, and as such they can be neither overtly observed nor explicitly measured or manipulated. In addition, the relevant studies focused on broad and multi-factorial indicators of healthcare delivery (e.g., admission for surgery), while evidence regarding the impact of stereotypes on medical decision-making is very limited. It is further argued that despite evidence produced by the social and cognitive sciences that implicit assessment is the only reliable way to assess stereotypical thinking, a systematic approach to studying implicit bias in healthcare does not appear to have been taken. Based on current documentation, a shift away from the use of complex multifaceted indicators of healthcare towards a focus on medical decision-making is suggested, and specific lines of research are proposed, with the use of implicit measurements in stereotype assessment.

Key words: Implicit assessments, Implicit bias, Medical decision-making, Stereotypes.