Person-centered care is a benchmark for high-value healthcare. The expectation of person-centered care is that healthcare providers will make clinical decisions based on evidence-based practices and each patient's individual needs. Implicit bias is an obstacle that often goes unrecognized yet can impede the delivery of optimum patient care. Healthcare professionals must understand how implicit bias affects healthcare in order to deliver inclusive care for all patients.
What is implicit bias?
Implicit bias refers to the unconscious attitudes or stereotypes that individuals hold about certain groups of people. These biases can affect our understanding, actions, and decisions in ways we may not even realize. Everyone, regardless of their background or experience, holds implicit biases. Various factors shape these biases, including personal experiences, cultural norms, societal influences, and media portrayals.
How implicit bias affects healthcare providers
Implicit bias can profoundly influence healthcare providers' behavior and decision-making processes. These unconscious beliefs can inadvertently shape clinical interactions and care pathways in several ways:
- Clinical Decision-making: Providers may unknowingly allow their biases to influence diagnoses and treatment plans. For instance, a doctor may unconsciously associate certain symptoms with a particular demographic and overlook or misdiagnose conditions in patients outside that group.
- Provider-Patient Interactions: Implicit biases can impact a healthcare professional's rapport with a patient. Patients may sense the provider’s biases, leading to mistrust, reduced adherence, and less engagement in their care.
- Treatment Recommendations: Implicit biases can lead to differential treatment of patients based on factors unrelated to their health or the severity of their conditions. For example, a provider might recommend physical therapy for a young patient but just medication for an older patient based on assumptions about activity levels.
- Communication Barriers: Biases related to language, accent, or socioeconomic status can lead to miscommunication. Providers might over-simplify medical information or avoid in-depth discussions, presuming that the patient will need help understanding.
- Reduced Empathy and Compassion: If a provider subconsciously holds biases against a particular group, they may demonstrate reduced empathy and understanding for patients from that group, affecting the quality of care delivered.
Recognizing the pervasive nature of implicit bias is the first step for healthcare providers to actively combat its impact and ensure equitable, patient-centered care for all.
Examples of implicit bias in healthcare
Implicit bias in healthcare manifests in various ways, often leading to differential treatment based on personal characteristics rather than medical necessity. Here are some examples:
- Age Bias: A younger patient with chest pain might be diagnosed with anxiety or stress, while an older patient with the same symptoms could be immediately tested for heart disease. Implicitly, the provider might rely on stereotypes about which age groups are more susceptible to certain conditions.
- Gender Bias: Studies have shown that healthcare providers often take women's pain less seriously than men's. For example, a woman might be told her severe abdominal pain is "just cramps" or related to her menstrual cycle. A man with similar symptoms might be more quickly evaluated for conditions like appendicitis or gallstones. (LINK TO IBM)
- Racial and Ethnic Bias: Some healthcare providers might unconsciously believe that certain racial or ethnic groups have higher pain tolerances or are more likely to seek medications for illicit use. As a result, patients from these groups might not receive adequate pain management or face additional scrutiny when requesting certain medications. (LINK TO RHE)
- Weight Bias: Overweight patients often report feeling judged or stigmatized by medical professionals. This bias might lead providers to attribute an overweight patient's medical issue to their weight, potentially overlooking other causes or conditions.
- Socioeconomic Status Bias: A patient's appearance, clothing, or lack of insurance might lead a provider to make assumptions about their health behaviors, compliance with treatment, or even their intelligence. A patient in worn-out clothing might be presumed to be non-compliant with medications because of unconscious biases about poverty and responsibility.
- Language and Accent Bias: Patients with an accent or limited English proficiency might be perceived as less knowledgeable. This can lead to providers oversimplifying their explanations or not providing the full range of treatment options. (LINK TO LEP)
The need for implicit bias training in healthcare
The consequences of unaddressed implicit bias in healthcare are significant. Healthcare organizations must implement ongoing training to mitigate how implicit bias affects healthcare professionals. Online implicit bias training is pivotal in raising awareness among healthcare providers about their implicit biases, prompting introspection and self-awareness.
Choosing a subscription-based health equity platform like Quality Interactions allows healthcare staff to engage in on-demand training that aligns with their busy schedules. The platform's scalability also ensures that your entire healthcare staff can continually learn, enabling institution-wide understanding and action against bias. By investing in implicit bias training, healthcare institutions boost the quality of patient care and reinforce their commitment to person-centered care, health equity, and the highest standard of healthcare.
Further reading on implicit bias in healthcare: