Just Medicine: A Cure for Racial Inequality in American Health Care

Chapter 2 of Just Medicine opens with the section “Explaining a Blind Spot,” in which Matthew discusses the persistence of racial and ethnic health disparities, attributing them to implicit biases among physicians rather than conscious racism. Through interviews, she finds that many doctors are either unaware of health disparities or deny that bias affects their practice. Despite their altruistic intentions, physicians often unconsciously rely on stereotypes when diagnosing and treating patients, which contributes to inequitable care. Matthew emphasizes that implicit bias, driven by learned patterns and automatic judgments, infiltrates medical decision-making, despite doctors’ belief in their objectivity.

In the section “Understanding Implicit Bias,” Matthew explains that physicians, like all people, unconsciously form negative associations based on stereotypes stored from a lifetime of social exposure. These biases, formed without awareness, influence professional behavior more than consciously held beliefs. When doctors interact with patients, their stored stereotypes are triggered almost instantly, shaping their perceptions and decisions. Despite their good intentions to provide equitable care, implicit biases lead to harmful treatment disparities.

Matthew discusses the prevalence of implicit biases, particularly anti-Black and pro-white attitudes, among Americans, including healthcare professionals. She presents research that shows that implicit biases remain widespread and harmful, especially in healthcare. Implicit biases operate unconsciously, triggered by stored social knowledge gathered from media, politics, and everyday interactions, often reinforcing stereotypes about BIPOC groups.