The Effect of Medical Authoritarianism on Physicians' Treatment Decisions and Attitudes Regarding Chronic Pain1,*

Abstract

This study examined the influence of medical authoritarianism (MA) on physicians' treatment decisions and attitudes regarding chronic pain among a randomly selected sample of primary care physicians (N = 382) who responded to a mail survey. As hypothesized, high‐MA physicians had more negative attitudes toward chronic pain patients, greater concerns about prescription drug abuse, and more negative attitudes toward the use of opioids to treat chronic pain than did low‐MA physicians. Despite these negative attitudes, high‐MA physicians were more likely than were low‐MA physicians to recommend the aggressive use of opioids. The results point to the complex relationship between MA and physician attitudes and decisions, and provide insights into how political ideology might influence physician behavior.

A Systematic Review of the Extent and Measurement of Healthcare Provider Racism

“…Meritocracy, justworld beliefs 88 and White racial identity, privilege and guilt 89 are also important constructs that were assessed in only two of the included studies. 27,28 Other important constructs that remain unexamined to date include ideologies such as color-blindness (i.e., treating everyone the same regardless of their race/ethnicity), multiculturalism (i.e., recognition and celebration of racial/ ethnic difference) and anti-racism (i.e., targeted efforts to address racial disparities through, for example, affirmative action), 90 genetic determinism (i.e., genes determine life chances) 91 and essentialism (i.e., differences between racial/ ethnic groups are natural and inherent), 92 perceived status differences (i.e., prestige/success of racial/ethnic groups), 93 medical authoritarianism (i.e., belief in hierarchical relationships between providers and patients), 94 social dominance orientation (i.e., belief that some racial/ethnic groups are or should be superior to others) 95 and materialism (i.e., the important of acquiring and owning possessions), 96 as well as realistic threat (e.g., migrants 'stealing' jobs) and symbolic threat (e.g., migrants jeopardizing national values). 97 Given the extensive research conducted on patient-provider communication, 13,98,99 the relationship between racism and communication requires investigation (e.g., Hagiwara).…”

Under the Radar: How Unexamined Biases in Decision-Making Processes in Clinical Interactions Can Contribute to Health Care Disparities

“…41 Neglect of pain medication might also indicate passive harm. 42 These are empirical questions to investigate.…”

The Impact of Racism on Clinician Cognition, Behavior, and Clinical Decision Making

“…Instead, bias might be more effectively reduced among clinicians high in SDO or RWA by emphasizing universal application of norms, rules, and guidelines. In fact, clinicians high on RWA and MA may be particularly likely to be compliant with guidelines (Burgess et al, Forthcoming; Phelan et al, 2009). For this group, then, guideline-driven quality improvement efforts may be the most effective pathway to more equitable care.…”