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Abstract 206: Gender Bias among Cardiology Physicians


 Background:
 Physician bias is a likely contributor to gender disparities in the use of cardiac procedures. The Implicit Association Test (IAT) is a validated tool to measure implicit (unconscious) attitudes but has not been used to study gender disparities in health care. We measured attitudes around patient gender among cardiology physicians using the IAT.
 
 
 Methods:
 We developed two web-based IATs focused on gender attitudes applicable to cardiology procedures. The IAT measures implicit biases by comparing the speed with which concepts can be sorted, when paired in different combinations (i.e. women=strength and men=weakness vs. men=strength and women=weakness). The Strong-IAT measured gender associations with “strength versus weakness” and the Risk-IAT measured gender associations with “risk-taker versus risk-averse”. The IAT is scored from –2.0 to +2.0 with negative scores suggesting a pro-female bias (e.g. women are stronger than men), a positive score suggesting a pro-male bias (e.g. men are stronger than women) and “0” meaning no bias. We emailed a web-based survey including the IATs to all physician members of a state cardiology association. Potential participants received three weekly reminders and, for validation purposes, a subset re-took the survey after 30-days.
 
 
 Results:
 Of the 317 cardiology physicians with valid email addresses, 52 (16.4%) completed the survey. Participants’ mean age was 48.2 (+/- 12.1), 81% were male, and 77% were white. Most (63%) were non-invasive cardiologists (22% interventional cardiologists and 16% electrophysiologists) and 67% practiced in an academic setting. The mean Strong-IAT score was 0.60 (SD = 0 .42) and Risk-IAT score was 0.45 (SD = 0.54) revealing a significant pro-male bias. Over 38% had a high degree of pro-male bias for both IATs (Figure). Among the 11 participants who retook the survey, test-retest reliability was high (Strong-IAT r=0.68; Risk-IAT r=0.79).
 
 
 Conclusions:
 On average, cardiology physicians exhibited implicit gender bias suggesting they are more likely to view men as being stronger and more likely to take risks than women. These attitudes appeared to be relatively stable over time. Future work is needed to understand whether these attitudes influence treatment decisions and contribute to gender disparities in cardiology care.
 
 
 
