The effects of patient sex and race on medical students' ratings of quality of life

PURPOSE: Although previous studies have examined race and sex differences i n health care, few studies have investigated the possible role of physician bias. We evaluated the influence of race and sex on medical students' perc eptions of patients' symptoms to determine if there are differences in thes e perceptions early in medical training. SUBJECTS AND METHODS: One-hundred sixty-four medical students were randomly assigned to view a video of a black female or white male actor portraying patients with identical symptoms of angina. We evaluated students' percepti ons of the actors' health state (based on their assessment of quality of li fe) using a visual analog scale and a standard rating technique, as well as the type of chest pain diagnosis. RESULTS: Students assigned a lower value (indicating a less desirable healt h state) to the black woman than to the white man with identical symptoms [ visual scale (mean +/- SD): 72 +/- 13 vs 67 +/- 12, P <0.02; standard gambl e: 87 +/- 10 vs 80 +/- 15, P < 0.001). Nonminority students reported higher mean values for the white male patient (standard gamble: 89 +/- 8 vs 81 +/ - 14 for the black female patient), whereas minority students' assessments did not differ by patient. Male students assigned a slightly lower value to the black female patient (standard gamble: 76 +/- 16 vs 87 +/- 10 for the white male patient). Students were less likely to characterize the black fe male patient's symptoms as angina (46% vs 74% for the white male patient, P = 0.001). CONCLUSIONS: The way that medical students perceive patient symptoms appear s to be affected by nonmedical factors. (C) 2000 by Excerpta Medica, Inc.