Patients' and physicians' biased behaviours during pre-anaesthesia consultation: The BiPAC prospective survey study

The physician-patient relationship can be undermined by biased behaviours. There is a lack of epidemiological data in Europe and in the field of anaesthesia.

BiPAC is a prospective and bicentric survey study, conducted in a public and a private hospital. We recruited both the patient and the physician during consultation. A biased behaviour is defined as any action or statement perceived as degrading.

A total of 1980 patients were included, and physicians returned 258 questionnaires. Biased behaviour from the physician was experienced by 3.7% of the patients. The consequences were poor answers, disrespectful remarks, and denial of care. Patients encountering difficulties with the French language were more likely to be experiencing biased behaviour (OR = 6.90 [1.34-35.48]; p < 0.001), as were LGBTQ patients (OR=3.32 [1.38-7.97] ; p = 0.007). In contrast, being seen in a private centre was a protective factor (OR=0.52 [0.27-0.99]; p = 0.046). Biased behaviour from patients was experienced by 2.1% (n=63) of the physicians. Being a woman (p = 0.039) and European (p < 0.001) were risk factors. In multivariate analyses, being 60 years or older was a protective factor (OR=0.21 [0.09-0.54]; p = 0.001) while being a resident was a risk factor (OR=2.7 [1.38-5.68]; p = 0.004).

Biased behaviours during pre-anaesthesia consultations, even when perceived as harmless, undermined patient trust, understanding, and perceptions of physician competence. Language barriers and identifying as LGBTQ were risk factors for patients, whereas belonging to an ethnic minority group was not. Among physicians, being a woman, a resident, or younger in age was associated with greater exposure.