Implicit Bias Is Still a Hallmark of Patient Experience

The patient experience is still being impacted by implicit bias, despite industry calls to promote health equity, according to the results of a MITRE-Harris Poll Survey on Patient Experience.

Overall, four in 10 patients of any demographic group said they perceive their healthcare providers as biased against them. Hispanic and Black patients were more likely to report as much compared with any other demographic group, the survey found.

However, other demographic groups—those with chronic illness, family caregivers, and members of the LGBTQIA+ community—also reported bias, doubt, and language barriers when seeking medical treatment.

“These findings confirm unacceptable disparities in patient experience along racial and ethnic lines, for the LGBTQ+ community, and for those who are managing chronic health conditions or navigating the world with disabilities,” Juliette Forstenzer Espinosa, senior Medicare, Medicaid, and Affordable Care Act Marketplace strategist at MITRE, said in a statement. “And these categories are, of course, intersectional. There’s no question there is work to do to better serve all populations at the point-of-care.”

These findings illustrate some continued issues with the patient experience. Around half of the nearly 2,000 survey respondents said they felt ignored, dismissed, or not believed when they are interacting with their healthcare provider. That figured jumped to six in 10 when looking just at Hispanic patients, the survey showed.

And as patients say their providers are not listening to them, clinicians are also making assumptions, the survey results showed. Half of respondents said their healthcare provider had made an assumption about them without asking the patient first, indicating some implicit bias on the part of the clinician.

This comes after a few years during which health equity was front and center. After the COVID-19 pandemic illuminated long-standing health disparities, medical leaders across the country made pledges to tackle health equity. These findings indicate that there is still more work to be done.

Perhaps most egregious are findings about patient portal use. Patient portal use has become nearly ubiquitous, with nine in 10 respondents using the tool more often to view lab results (70 percent), to make appointments (65 percent), and view their medical records (63) percent than other technologies.

Notably, Black and Hispanic patients were more likely to use patient portal technology than their White counterparts. Even still, patient navigation is elusive for those racial groups, said Rob Jekielek, managing director of The Harris Poll.

“With the evolution of online patient portals and digital support tools, we have seen stronger usage among those who need to navigate the system the most—individuals with a chronic illness or disability and those who manage the healthcare needs of others,” Jekielek explained.

“However, this has not translated to substantially lower frustration with the healthcare system, including understanding of coverage and claims. Confusion and uncertainty are even higher among the majority of Americans who use the system sporadically, or only when specific needs arise.”

About half of the respondents said they are confused about paying their medical bills, with 54 percent reporting that they don’t know whom to contact if they have a question about their bill or claim. That issue is less common among folks who have to engage more often or more intensely with the healthcare system, like those who say they have a disability or are chronically ill, as well as their caregivers.

Younger patients and Hispanic people were also more likely to say they know whom to contact with a bill pay question.

Also, in the realm of patient financial responsibility, the researchers found that surprise medical billing is on the downswing. This year, 43 percent of respondents said they received a surprise medical bill, down from 47 percent who said the same last year.

Finally, the survey showed that patient appointment wait times are still an issue for the industry. Respondents said getting imaging appointments or visits with their primary care providers is reasonable, with most saying it only takes about two weeks. However, a fifth of patients said it can take up to two months to get an appointment with a specialist.