Author Affiliations: Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis (Dr van Ryn); Section of General Internal Medicine, Portland VA Medical Center, and Division of General Internal Medicine & Geriatrics, Oregon Health & Science University, Portland (Dr Saha).
The evidence that physician behavior and decision making may contribute to racial inequalities in health care1- 5 is difficult to reconcile with the fact that most physicians are genuinely motivated to provide good care to all their patients.6 This apparent contradiction can cause considerable cognitive dissonance, the uncomfortable feeling that occurs when holding 2 conflicting ideas simultaneously. Cognitive dissonance has been shown to be so aversive that people are highly motivated to resolve it, often by discounting the evidence supporting one of the conflicting beliefs. For scientists, however, cognitive dissonance motivates inquiry into how 2 seemingly contradictory sets of facts can coexist. The study by Haider and colleagues7 in this issue of JAMA is part of a growing body of work applying concepts and methods from cognitive and social psychology to medical care and education research to understand and inform interventions to eliminate the physician contribution to racial inequalities in care.
van Ryn M, Saha S. Exploring Unconscious Bias in Disparities Research and Medical Education. JAMA. 2011;306(9):995-996. doi:10.1001/jama.2011.1275