Symptoms of physician burnout appear to be associated with greater bias toward black people in this study of nearly 3,400 second-year resident physicians in the United States who identified as nonblack.

However, since this is simply an observational study it cannot determine if the suggested association between symptoms of burnout and bias toward black people is causal and the magnitude of the observed association was small to medium.

Only data from resident physicians who self-identified as belonging to a racial group other than black (n = 3392) were included in the analyses because of scarce evidence of racial bias in the care provided to black patients by black physicians. Resident physicians training in radiology or pathology were excluded because they provided less direct patient interaction. Survey data from questionnaires that were part of another study were used. About 45% of physician residents had symptoms of burnout.

Explicit bias was measured on a "feeling thermometer" with the lowest score meaning cold or unfavorable toward black people and the highest score meaning warm or favorable; implict bias was measured on a test that involved sorting pictures of white and black people and words to describe them including "good" and "bad."

The authors write that given the high prevalence of burnout among resident physicians and the negative association between bias and suboptimal medical care, symptoms of burnout may be factors in disparities in care; the implications for the quality of care provided to black people and other disadvantaged groups could be substantial.

Citation: JAMA Netw Open. 2019;2(7):e197457. doi:10.1001/jamanetworkopen.2019.7457