Implicit Bias in Healthcare and How to Combat It

Having subconscious biases can impact the quality of care you offer patients. But how can you put a stop to biases you're not even aware of? The answer is implicit bias training.

“Implicit bias” refers to the subconscious biases we hold that affect our understanding, actions, reactions and decisions in an unconscious way. Implicit bias is not limited to race, but can exist for characteristics such as gender, age, sexual orientation, gender identity, disability status, religion, and physical appearance such as height or weight. Categorizing people by these characteristics can lead to stereotyping, prejudices and discrimination. In healthcare, implicit biases can lead to different, unequal healthcare treatment and sabotage patient relationships. And it is not just your words — your body language can unknowingly express your implicit biases.

Recognition is the First Step

As is necessary with most change-oriented behavior, the first step is to recognize your own implicit biases so you can face them. Implicit bias training can help you accomplish this self-realization. Once you are aware, recognize where the biases may exist within your patient population and consciously make an effort to resist stereotyping and challenge your viewpoints. Training or awareness education on this topic should not be considered a “one and done” event. Implicit biases are built into us and it takes some time to overcome them. Some recommended strategies to reduce implicit biases from the Institute for Healthcare Improvement (IHI):

Strategies to Reduce Implicit Bias

  • Stereotype replacement: Recognize that a response is based on stereotype and consciously adjust the response.
  • Counter-stereotypic imaging: Imagine the individual as the opposite of the stereotype.
  • Individuation: See the person as an individual rather than a stereotype (e.g., learn about their personal history and the context that brought them to the doctor’s office or health center).
  • Perspective-taking: Put yourself in the other person’s shoes.
  • Increase networking opportunities: Expand your network of friends and colleagues and/or attend events where people of other racial and ethnic groups, gender identities, sexual orientation, and other groups may be present.
  • Partnership building: Reframe the interaction with the patient as one between collaborating equals.

Implicit bias education and training is gaining much-needed support from the government. For example, the governor of Michigan has requested the Department of Licensing and Regulatory Actions to develop rules requiring implicit bias training as part of the licensure for healthcare providers.

Read more about implicit bias in healthcare through the IHI, find a resource for implicit bias training, or identify your own implicit biases with this free online test from Harvard.

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