Curbing bias in healthcare through conversations

by Garret Sample

Doctor jacket and stethoscope
Thomas Jefferson University Hospital wants doctors, nurses, and staff to be conscious of how bias can affect patient outcomes.
Photo credit
 Julio César Velásquez Mejía, Pixabay 

Every month, a major Philadelphia healthcare provider discusses appropriate ways to view and treat one another by raising awareness and educating providers, staff and patients about inequality, unconscious bias, representation and community engagement.

 The Office of Diversity & Inclusion at Thomas Jefferson University Hospital holds town hall-style webinars open to patients and residents of Philadelphia, Delaware, Bucks and Montgomery counties to discuss these issues that matter in healthcare. 

The “Let’s Talk” town-hall discussions are educational workshops. Jefferson’s Executive Vice President of Diversity & Inclusion, Lissette Martinez, said experts from across the globe speak at the townhalls on “every topic imaginable related to interactions in healthcare communities.” She said these workshops help. 

In September, the panel discussion centered on managing micro-aggressions and speaking up to peers. The conversation in October highlighted the unconscious bias of providers and its interference with providing optimal patient care.

Martinez emphasizes that bias can be positive or negative and can take many shapes. Unlike explicit bias, unconscious bias is not pejorative and blatant. Unconscious bias can be difficult to change because the individual or group is not consciously acting to cause the eventual impact. 

The impact, or result, of unconscious bias, may appear to the person on the receiving end as an intentional act. Thus, impact and intent are often at the core of patient and provider misunderstandings and complaints. 

One of the tools healthcare providers use to raise awareness of unconscious bias is an implicit association test. This tool allows providers to discover where their sensitivities lie and where they need to work on recognizing their biases.

 Microagressions are verbal and behavioral slights that are the result of bias. They are often automatic and even can be unintentional from the perspective of the perpetrator. 

Microagressions can range from using inappropriate humor regarding different groups in a private or public setting to making statements that deny ethnic experiences like, “There is only one race, the human race.” 

It is important to remember that these aggressions can stem from unconscious bias, which we all have. Understanding our negative biases can allow us to shift our behavior to less harmful ways.

Danielle Hill, 39, is an African American woman from the inner city of Philadelphia. Her race and gender make her part of two marginalized communities. She is further marginalized as a single mother of a 21-month-old daughter.

Hill describes unconscious bias as a predetermined mindset about culture, race, ethnicity, or gender. Based on interactions with the healthcare community, she knows all too well the bias that can interfere with adequate patient treatment. The mindset, from her perspective, can alter assessments, diagnoses, and modes of treatment. 

Hill said bias directly impacted her and her family. First, it came in the form of a mediocre assessment. Then, a late diagnosis left very few options once the illness was discovered.

Hill and her family were told the issues their loved one faced were “not a big deal.” However, a lack of follow-up care and outreach after the diagnosis left an already confused patient without clarity.

Many people of low-income and marginalized households and communities have limited medical knowledge. They do not know when a lack of trust in their provider’s decisions is warranted. Once the impact of such a situation is realized, the trust between patient and provider is broken, however all too late.

 Hill’s story is not uncommon. 

To make a positive contribution in combating bias, assess personal biases and those of friends and the community. Awareness of biases through routine critiquing of behaviors and actions can minimize others feeling the impact of bias.

Help for holding critical conversations on diversity

Start conversations about diversity and equity.

Click to see topics, resources and programs on diversity that Delaware County Intermediate Unit offers.

Who Me? Biased? Take Hidden Bias Tests

Psychologists at Harvard, the University of Virginia and the University of Washington created short tests to measure unconscious bias. Check to see how conscious you are of your biases. Click to take short tests on many types of implicit associations: gender and science, Asian, weapons, trauma, skin tone, Arab-Muslim, religion, weight, sexuality, presidents, disabilities, gender-career and race.

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