ArticleBMC primary care2025
The role of racial and socioeconomic status bias on medication prescribing practices: a qualitative study of family physician perspectives.
Article in BMC primary care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPhysicians' prescribing practices can be influenced by racial and socioeconomic status (SES) biases in a manner that impacts the well-being of patients. Little is known about this issue in the Canadian context. In this study, we set out to understand how family physicians perceive the role of racial and SES bias in prescription conversations and prescribing decisions for patients who have chronic diseases.
methodsIn this qualitative study, we recruited family physicians working at hospital-affiliated family medicine clinics in Toronto. Recruitment occurred through department-wide emails sent by their colleagues who were co-investigators in the study. Participants included men and women, and those who self-identified as minority racialized groups. Semi-structured in-depth interviews explored participant thoughts about racial and SES bias in prescribing practices. Participants were also presented with US-based studies on this topic and asked to reflect about the Canadian context. Interviews and field notes were recorded, transcribed verbatim, and coded. The research team interpreted and analyzed the data using a combined inductive and deductive approach.
resultsThirteen family physicians ranging in age (25 to 50 years) and years of practice (> 1 to < 25) were recruited. Most participants acknowledged awareness of their own bias; when asked, only a few discussed treating all patients equally irrespective of race. Participants perceived bias to affect their prescribing practices both positively and negatively. They explained bias through the lens of power differentials and cultural differences, emphasizing how a lack of diversity among family physicians exacerbates racial and SES bias.
conclusionsUnderstanding the influence of bias from physicians' perspective might help improve prescription practices for patients with chronic diseases and make care more equitable or fair for racialized people, people with lower SES, and individuals at the intersection of these social locations. These findings highlight the need for targeted interventions, such as increased diversity in medical practice, to promote more equitable prescribing practices and improve patient care.
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