Do clinicians have an implicit bias in favor of specific disease over nonspecific illness?

Background: Some patients and clinicians have an explicit preference to associate symptoms with specific pathology. This bias can manifest in relatively specific names for illnesses with nonspecific symptoms and signs such as radial tunnel syndrome, repetitive strain injury, and fibromyalgia. This might be a manifestation of a desire for a sense of control and measurable as an unconscious bias for specific over non-specific illnesses.

Questions: There are no factors independently associated with orthopedic surgeon unconscious bias against non-specific illness; Is there a relationship between clinician unconscious bias and clinician explicit preference regarding non-specific illness?

Patients and methods: An implicit association test was used to evaluate clinician implicit bias regarding specific and nonspecific illnesses. Demographic information and explicit preference were collected from consented clinicians.

Results: Musculoskeletal clinicians have moderate explicit (conscious) and implicit (unconscious) bias in favor of specific illnesses over nonspecific illnesses.

Conclusions: Musculoskeletal clinicians explicitly and implicitly favor specific over nonspecific illnesses.

Clinical relevance: Given the notable prevalence of symptoms that are never associated with discrete pathology, care strategies designed to neutralize bias against non-specific illness have the potential to reduce low value tests and treatments; 2) avoid diagnoses that imply specific pathology when the illness is characterized by the absence of verifiable objective pathology; and 3) prioritize interventions known to enhance health among people with no identifiable pathology.