The health care system in the USA has been in a state of upheaval for years: gradually the workforce is becoming more female and more diverse – the long prevailing high proportion of white males among doctors is falling.

But has this change also reached consciousness? This is what researchers from ETH Zurich wanted to find out in an experiment in the USA. The bitter truth: A placebo is significantly more effective when administered by a white man. At least this applies to the 187 white test persons of different ages who were allegedly tested for allergies.

Even if the subjects have no reservations about doctors or black doctors, their physical reactions make the unconscious prejudices visible. The placebo effect is significantly weaker if the treating person does not correspond to the stereotype “white man”.

Put simply, the placebo effect causes someone to believe in the healing properties of a drug or method, and these positive expectations then activate certain brain regions in the hypothalamus, the brain’s control center that regulates important bodily functions such as emotions and thinking. The positive thought is enough to cause physical reactions.

In the experiment published in the journal PNAS, an allergic skin reaction was initially triggered in the test subjects. They were then given a cream that was supposed to have a soothing effect, but was in fact a completely ineffective lotion. The subjects were treated at random by a doctor who was Asian, black or white.

The test subjects reacted very differently to the standardized experiment, depending on who triggered the allergic reaction or applied the placebo: When a medical woman applied the supposedly healing ointment, the allergic reaction became stronger than when a man carried out the same treatment.

Different skin colors also evoked different reactions: if a black doctor triggered the allergic reaction, a significantly larger area of ​​the test person’s skin reddened than if an Asian-looking or white doctor triggered the same allergic reaction. And the supposedly soothing ointment, applied by a black doctor, didn’t help as well.

The unconscious physical reactions clearly prove prejudices, at least for the exclusively white test participants, even if the test persons were not aware of this at all. If the treating person did not correspond to the expected stereotype, patients reacted more violently and were less convinced of the benefit of the treatment. This also applied to patients treated by female doctors.

“If a doctor doesn’t look like someone who has had that role for most of history — that is, if the doctor isn’t a white male — patients may be less responsive to treatment,” said study physician Dr Lauren Howe from the University of Zurich.

According to Howe, these different reactions are also astonishing because the test subjects basically tried to be unbiased and unprejudiced in the doctor-patient relationship. When evaluating video recordings of the treatments, 1,400 volunteers found the white subjects to be more interested and polite when a black doctor carried out the treatment.

But her body still reacted differently. According to the study, “The findings illustrate how beliefs about race and gender can affect patients subliminally – literally under the skin – despite their stated intentions and even to their own detriment.”

This was also confirmed by doctor Howe. “The results show how deep prejudices are.”

Author: Alexander Freund

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