Addressing Implicit Biases In Healthcare: Why It Matters And What Leaders Can Do About It

The healthcare industry is built upon the principle of providing equal and quality care to all patients, regardless of their race, gender, socioeconomic status or any other characteristics. As healthcare professionals, we often like to think of ourselves as objective and rational. We base our decisions on evidence and best practices, not personal feelings or preconceptions.

But the truth is, we all have biases. It’s how our brains are wired. And our implicit biases—which are attitudes or stereotypes that affect our understanding, actions and decisions unconsciously—can have serious consequences in healthcare settings. Because despite our good intentions, we may unknowingly be providing unequal or lower-quality care to certain groups of people and contributing to health disparities.

Acknowledging the existence of implicit bias is an important first step. From there, individually and collectively, we can work toward creating a culture and environment where all patients receive fair and equitable treatment.

Understanding Implicit Biases

Implicit biases can be both positive and negative. For example, you may have an implicit bias that led you to choose your current career path. And we all have them—even people who consider themselves to be open-minded and egalitarian. That’s because biases develop over time and are shaped by our personal experiences, exposure to various media and social norms. They can exist without our conscious knowledge or awareness and can contradict our stated beliefs or values. But they influence our behavior in very real ways.

Implicit Biases In Healthcare

In healthcare settings, these biases can lead to disparities in the quality of care for certain people. For example, a physician may have an implicit bias against a certain racial group that impacts their diagnosis or treatment plan for those patients. These biases can also affect hiring and promotion practices within healthcare organizations, leading to a lack of diversity in leadership positions. Not only does this contribute to inequitable care, but it also limits the perspectives and ideas that inform decision-making at all levels of the organization. Here are a few other examples of how biases can manifest in healthcare settings:

• Bias can influence which patients receive appropriate preventative care, leading to health disparities.

• Healthcare providers may overlook or dismiss certain symptoms in patients, resulting in delayed or improper treatment.

• The level of attention and respect given to a patient can be impacted by bias, affecting the patient's experience and potential adherence to treatment plans.

• Bias can influence how medical research is conducted, potentially leading to unequal representation of certain demographics in studies and subsequent biases in recommended treatments.

• Bias can contribute to communication barriers between healthcare providers and patients, resulting in misunderstandings and misdiagnoses.

• Bias can show up in decision-making processes, such as triage, affecting who is prioritized for treatment.

• The level of trust and rapport built between patients and healthcare providers can be disrupted, leading to lower satisfaction and overall effectiveness of care.

• Stereotyping and assumptions may be made about a patient's adherence or compliance with treatment plans.

• Bias can affect referral patterns, potentially limiting access to specialized or high-quality care for certain demographics.

• Hiring and advancement opportunities may also be impacted, leading to a lack of diversity in the workforce and perpetuation of systemic biases within the industry.

Creating Organizational Change

There is no easy solution, but one critical step is increasing awareness and understanding of these biases in order to overcome them and promote equitable care for all patients. This requires ongoing effort, but taking steps to address these biases can ultimately lead to better outcomes for both individual patients and the healthcare system as a whole.

• Establish education and training programs to recognize and counteract biases and address the impacts of implicit bias in healthcare settings.

• Make proactive efforts to seek out diverse perspectives.

• Prioritize continuous self-reflection and accountability.

• Regularly examine personal attitudes and beliefs.

• Frequently review policies and procedures to identify potential biases and work toward eliminating them.

It is also important to recognize the systemic issues that contribute to unequal treatment in healthcare and advocate for changes at a larger level. This can include advocating for diversity in leadership positions and healthcare policy making, as well as pushing for equitable distribution of resources.

Identifying Your Own Biases

There are many ways to start identifying your own biases, but one of the easiest is to take a quick test that measures the strength of your associations between concepts (such as race or gender) and evaluations (positive or negative) or stereotypes. For example, Harvard has a great test you can try out. However, it is important to keep in mind that these tests are not perfect and cannot provide a definitive understanding of our biases.

So, make sure you are continually reflecting on your past behaviors and decisions. Have you ever caught yourself making snap judgments about others based on their appearance or assuming certain things about them? Have you made assumptions about a patient's health based on their race or socioeconomic status—even unintentionally?

It is no secret that implicit biases can have detrimental effects and lead to unequal treatment, misdiagnoses and even fatalities. And all healthcare professionals, regardless of background or personal beliefs, have implicit biases. The key is to acknowledge these biases, actively work at overcoming them and constantly strive for equitable care for all patients. It is an ongoing process, but taking steps toward overcoming implicit biases in healthcare is vital for improving patient outcomes and promoting health justice.

Previously published on Forbes.