Study finds racial bias may be conveyed through physician's body language

People often say communication is 7 percent verbal and 93 percent nonverbal. This nonverbal portion of communication may be to blame in disparate outcomes between white and black patients at the end of life, according to a small study from Pittsburgh-based UPMC published in The Journal of Pain and Symptom Management.

Through the study, researchers hoped to identify if differences in communication attributed to the increased likelihood of death in the ICU among black patients, rather than white patients. Through randomized simulations, researchers tested 33 physicians to see if verbal and/or nonverbal communication affected black and white patient decisions and outcomes.

They found that while physicians said the same things to black and white patients verbally, they gave black patients less compassionate nonverbal cues.

"When explaining what was happening and what the next steps for care could be, with the white patients, the physicians were more likely to stand right at the patient's bedside and touch them in a sympathetic manner," senior author Amber Barnato, MD, associate professor of clinical and translational medicine in Pitt's School of Medicine, said in a statement. Simple body language cues during communication with both the patient and family members can result in vastly different impressions.

"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," Dr. Barnato said in a statement. "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. 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."

The report notes most of the physicians tested were white men, so it was difficult to see if physician's race impacted outcomes.


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