Implicit Bias in Social Media: Surgeon Name Affects Patient Perception of Surgical Competence
Deepa Bhat, MD1, Tejas Kollu, BS1, Joseph A. Ricci, MD2, Ashit Patel, MBChB, FACS1.
1Albany Medical Center, Albany, NY, USA, 2Montefiore Medical Center, Bronx, NY, USA.
Background: Implicit bias, the unconscious associations and beliefs held towards specific demographic groups, affects every day actions and decision-making. A surgeon that has an ethnically identifiable name, for example, can be subject to the implicit bias’ a patient holds towards that ethnicity. Social media, and specifically Instagram, is commonly used by plastic surgeons to market their practice. The aim of this study is to investigate whether a surgeon’s name on a social media platform influences perception of their competence, and their likelihood of gaining a new patient.
Methods: A mockup of an Instagram post was created using before and after photographs of a breast augmentation patient. Eight different ethnicities were selected and common female and male names were selected for each ethnicity based off of census data. Surveys using the Instagram post were designed asking respondents to evaluate the competency of the surgeon and how likely they are to become a patient of that plastic surgeon. The surgeon’s name was the only variable in the survey. Amazon MTurk crowd-sourcing was used to distribute the survey. Demographic data of respondents including sex, ethnicity and level of education was collected.
Results: A total of 2,965 survey responses were analyzed. The majority of respondents were Caucasian (57%); 55% were male and 45% were female. Overall, competence and recruitment likelihood scores between surgeons of different ethnicities were not significantly different. Caucasian and Latino responders both assigned higher competence and recruitment likelihood scores to their own respective ethnicities.
Conclusion: Implicit bias plays a role in whether or not a patient is likely to seek care from a surgeon with an ethnically identifiable name. The two most common cosmetic surgery demographic groups, Caucasians and Latinos, were also the only two ethnic groups to display in-group favoritism. Public education by our specialty should be directed towards surgeon qualifications and experience in an effort to reduce implicit bias on patient decision-making.
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