Results

The survey was completed by 620 people. The mean age was 44 years, 58 percent identified as female, the mean body mass index was 26, 73 percent were Caucasian, 78 percent were emergency physicians, and 72 percent were attending physicians.

Key Result: A high percentage of participants indicated IWB against other physicians, while other results suggested some EWB and PWB do exist.

• Implicit Weight Bias:
  • Eighty-seven percent of participants had a D-score above 0, indicating IWB against other physicians.
  • Male sex and increased age were both positively correlated with anti-fat weight bias.
• Explicit Weight Bias and Professional Weight Bias:
  • Ranges and means on the rating scales showed levels of variability, but overall suggested bias does exist.
  • Male sex positively correlated with both EWB and PWB.

Evidence-Based Medicine Commentary

1. Low r Values: The r value represents strength of correlations and ranges from (-1) to (+1), with 0 representing no association, (-1) representing maximal negative association, and (+1) representing maximal positive association. Correlations do not address causality between two things. Some of the r values for correlation in this study were low (0.24, 0.16, and 0.73). However, small correlations are in line with previous literature on the topic.7–9
2. Respondent Bias: Any survey literature is limited by respondent bias—when respondents know what they are being asked about, this may influence the honesty and accuracy of their answers. It would have been apparent to the physicians being surveyed that the study was about weight bias. Physicians are typically motivated and trained to control expression of their biases. This could have underestimated the amount of bias in this cohort. 
3. Externally Unvalidated Tool: The PWB scale was developed by this research group for this study. It was tested on emergency physicians and residents in the United States and Canada. We need to be cautious not to overinterpret the results until this tool has been externally validated with emergency physicians in other countries.

Bottom Line

Implicit, explicit, and professional biases exist in emergency physicians. Recognizing these biases can be a potential step to help mitigate the negative impact these biases may have on interprofessional relationships.

Case Resolution

You decide to speak truth to power and acknowledge that everyone has some biases. This specific comment about a candidate being overweight could suggest a possible interprofessional weight bias. You recommend to the other committee members that the weight of the candidate should not be part of the decision whether to promote the physician to a leadership position.

Thank you to Dr. Corey Heitz, an emergency physician in Roanoke, Virginia, for his help with this review.

Remember to be skeptical of anything you learn, even if you heard it on the Skeptics’ Guide to Emergency Medicine. Plus-circle