Do Doctors' Biases Affect Health Care?

Implicit biases change the way we act without us even realizing it, and doctors aren't immune. Learn how researchers are trying to help us all identify and change our unconscious biases in this episode of BrainStuff.

Learn more about your ad-choices at https://www.iheartpodcastnetwork.com

See omnystudio.com/listener for privacy information.

Episode Transcript

Speaker 1 (00:02):
Welcome to brain Stuff from How Stuff Works, Hey, brain
Stuff Lauren Vogelbaum here. Years of playing basketball had given
Damon Tweetie some bum knees. When the swelling didn't go
down on his left knee after a few days, he
went to an urgent care clinic for treatment. It was
his day off, and he was dressed in a T
shirt and sweatpants. He remembers the doctor never looked at me.

(00:24):
He just had me stand up, looked at my knees,
and then said, you'll be okay, take it easy. He
never even asked what kind of job I had. What
if Tweete's job required a lot of moving around in
a way it did. Damon Tweetie is a doctor himself,
and once he made that clear to the physician who
was treating him, everything changed. The doctor made eye contact
and started asking him questions. He even took Tweetie to

(00:46):
get an X ray. Tweet said, so it was an
example of two different levels of care. I was two
different people. First time, I was Damon Tweetie, random black
guy not to be taken seriously. In the second case,
I was Damon Tweete, m D and worthy of the
same care as anyone else, tweeted, told his story at
the Decatur Book Festival in Georgia and has written a

(01:07):
book that is part memoir and part discussion of bias
and medicine called black Man in a White Coat. Not
every medical mistep has to do with the accidental slip
of a scalpel or a medication dosing error. The unconscious
biases that everyone possesses, to one degree or another can
impact how a doctor cares for a patient. Wholly separate
from personally accepted prejudices like overt racism or homophobia, unconscious

(01:32):
biases are just that, biases that we don't even know
we have yet can impact how we treat others. We
also spoke with Renee Salazar, m d, a professor of
clinical medicine and the Director of Diversity in the Department
of Medicine at the University of California, San Francisco. She
put it this way, they're so deep within our psyche
that we're unaware of their existence. And we spoke with

(01:54):
Gordon Wallace, m d. Of the Canadian Medical Protective Association
via email. He explained that cognitive biases, or distortions of thinking,
are hardwired functions of the human brain, and they can
occasionally interfere with a doctor's ability to reach a correct diagnosis.
Racial bias is probably the most commonly studied type. However,
it's possible to harbor unconscious biases against all kinds of

(02:17):
people do for example, to their body weight, gender, or
sexual orientation. Cognitive bias isn't as obvious or easy to
pinpoint in a clinical setting because it isn't intentional. Many
studies have been conducted to determine whether or not doctors
possess unconscious biases, but one published in the Journal of
Internal Medicine took it a step further to measure how

(02:38):
these biases would actually affect treatment. In study, physicians using
an online tool were presented with randomized black and white
patients showing signs of coronary artery disease. The doctors assessed
the patients and recommended a course of treatment for each,
but the results showed that doctors more often suggested thrombolosis,
a treatment to break up blood clots, to the white patients,

(03:00):
while the black patients were left with less aggressive options.
The researchers drew the conclusion that unconscious biases can impact
the types of treatments prescribed to patients even when they
present the same symptoms as others. So if doctors are
completely unaware of their biases, how can they possibly change
their patient care strategies. Many turn to the implicit Association test,

(03:23):
a respected tool that assesses and reports on unconscious bias.
Dr Salazar said, what we find most often is there's
a disconnect between what people explicitly feel and what they
feel unconsciously. Once the results are available, it's easier to
be aware of personal cognitive biases and take steps to
minimize them. Many medical schools and hospitals are establishing curricula

(03:45):
to better train doctors on how to avoid the pitfalls
of cognitive bias, offering seminars and encouraging the use of
the I a T assessment tool. The Canadian Medical Protective
Association also backs up recommendations by expert Dr Pat Crosscerry,
an emergency physics and psychologist at Dalhousie University in Halifax,
Nova Scotia. Cross Carey suggests group decision making and consultation,

(04:07):
and the use of mindful reflection and slowing down strategies
to help the doctor deliberately transition from intuitive a k
A biased thinking to a more analytic mode. Following checklists
and computerized decision support systems also helped to remove the
human element, and experts suggest abiding by general rules of
thumb to avoid bias impact. For example, anyone exhibiting specific

(04:31):
neurological symptoms should always have their blood sugar tested. Self
awareness is also key to avoiding medical bias. Salazar explains,
just by knowing that these biases are there, we can
really take steps to reduce the impact. Let me stop
that process right now and make sure that I go
in with a clean slate and provide care with as
open a mind as possible. From a patient perspective, it's

(04:53):
not always going to be easy to figure out if
a medical provider is unconsciously biased against you or a
family member. To avoid being swept under the rug, ask
questions and document the answers, and never be afraid to
request an additional opinion or consult. Of course, doctors aren't
the only people who experience unconscious bias. You can take
an implicit association test online at implicit dot Harvard dot

(05:17):
a d u slash implicit to find out your true
opinions on a variety of issues, including sexual orientation, race,
and gender. The results could help you identify areas where
you could benefit from being more intentional, which, let's face it,
we've all got a few of. Today's episode was written

(05:38):
by Alia Hoyt and produced by Tyler Clang. Brain Stuff
has merched. Now you can contain your liquids, electronics, and
or body in brainy style by visiting t public dot
com slash brain stuff, and, of course, for lots more
on this and other intentional topics, visit our home planet,
how stuff works dot com.