Implicit Bias in Healthcare

EDITOR'S NOTE: Special thanks to Bet Martin for writing today's blog post. You can connect with her on LinkedIn.

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Learning to be our best

PULSARA'S HASHTAG:

#ItsAboutPeople

PULSARA'S MISSION:

We unite and empower people to improve health by simplifying care coordination.

Said another way...

The Pulsara Team places control back into the hands of clinicians and patients to create better outcomes.

Healthcare is complex. We make it simpler.

PULSARA VALUES

But more than that, we care about people. Our value of Servant Leadership means that we love people. We passionately serve people and the people who serve people. Our success is measured by the success of those we serve.

To begin to understand the rates at which minorities are disproportionately disadvantaged in the healthcare system, we as caregivers need to examine our implicit ethnic bias. Implicit social cognition, AKA implicit bias, is taking stereotypes (cultural conditioning) and applying them to our everyday thoughts, actions, activities, and practices.

Simply put, watch this quick video on Implicit Bias (from the IHI) ...

IMPLICIT BIAS IN MEDICINE

Implicit bias has been well documented by the National Academy of Medicine (NAM) in that “... ethnic minorities receive lower-quality health care than white people — even when insurance status, income, age, and severity of conditions are comparable.”  Simply put, minorities are dying at higher rates because of the color of their skin, and caregiver bias plays a large role in that.

MY EXPERIENCE IS THE SAME

Unfortunately, I’ve seen this in my own clinical practice. A few examples include:

• Pain medication being withheld from a patient in sickle cell crisis—and then seeing the patient labeled as a “drug seeker” in EHR documentation. These demonstrated a lack of compassion during an incredibly painful disease process.
• Poor triage notes labeling a patient with kidney failure as a “frequent flyer,” which is itself a discriminatory term. Implicit bias led to poor treatment, and eventually a poor outcome—ultimately resulting in an ethics committee review.
• Houseless people of color were not provided food or clothing, despite an obvious need; social resources were never provided, or discussed with a case manager.
• Frequent slow responses from healthcare organizations in addressing injustices raised by staff.

SO, WHAT WE CAN DO?

• Be the best providers we can be. Understand that we are ALL human; regardless of the “shade of brown” that we are. Our commitment as clinicians is to treat everyone with the absolutely best care we can with the absolute best knowledge and the absolute best intentions at heart. 
• Change “neural associations.” Studies show that we can change our implicit bias with new behaviors or thought processes — much like muscle memory from repetitive movements.
• Participate in the conversation. These resources help tell the story …
  • Between the World and Me by Ta-Nehisi Coates
  • Stamped From the Beginning: The Definitive History of Racist Ideas in America by Ibram X. Kendi
  • Implicit Bias — How It Effects Us and How We Push Through, a TED Talk by Melanie Funchess

I recently attended “White Coats for Black Lives,” organized and supported by the Seattle medical community. The keynote speaker, Dr. Williams (an esteemed Surgeon at Harborview Medical Center) shared, 

“The idea that asking for an equitable solution
only benefits black people is absurd,
it will benefit all of us.”

It’s our personal responsibility to be a patient advocate for EVERYONE.

It’s the mission and values of Pulsara, and mine. #ItsAboutPeople