Implicit bias in healthcare Implicit bias significantly affects how healthcare
health outcomes. Addressing implicit bias in healthcare is crucial for achieving equity in medical treatment. Strategies to combat these biases involve education and awareness programs for healthcare professionals. These programs help individuals recognize and acknowledge their biases, fostering a more empathetic and unbiased approach to patient care. Additionally, implementing policies and procedures prioritizing equitable treatment for all patients can play a pivotal role in reducing healthcare disparities. Ultimately, confronting implicit bias in healthcare is essential to creating a more just and equitable healthcare system where everyone receives fair and equal treatment regardless of their background or characteristics.
professionals perceive and make treatment decisions, ultimately resulting in disparities in health outcomes. These biases, often unconscious and unintentional, can shape behavior and produce differences in medical care along various lines, including race, ethnicity, gender identity, sexual orientation, age, and socioeconomic status. Healthcare disparities stemming from implicit bias can manifest in several ways. For example, a healthcare provider might unconsciously give less attention to a patient or make assumptions about their medical needs based on race, gender, or age. The unconscious assumptions can lead to delayed or inadequate care, misdiagnoses, or inappropriate treatments, all of which can adversely impact Pain assessment is considered a pivotal aspect of modern medicine. In a broader sense as a concept, pain assessment involves a comprehensive clinical judgment describing and analyzing pain based on the type, significance, and context of the patients’ experience. Describing pain with these assessment tools can be either difficult or easy depending on the demographics of the patients. In pediatric pain assessment, preverbal and developmentally disabled children might find it extremely difficult to properly describe the nature and severity of pain. In most cases, modern protocols for pain assessment in this population advise the use of behavioral tools in place of self-reported pain models. Medical personnel handling sessions of pain assessment in the pediatric population are trained to recognize, gauge, and document different behavioral cues necessary to improve pain assessment in children. In the geriatric population, pain assessment is more multidimensional, requiring the consideration of different behavioral and physiological cues. Case study 1—Beecroft’s career Beecroft lived a successful life as a featherweight weightlifting state champion. In her little province in northern Mexico, she quickly became the inspiration for young girls to strive for more and embrace sports. From one end of the suburbs to the large cities, she became the preacher of inspiration, championing a country-wide drive for the promotion of inclusive sports categories for young girls. However, Beecroft’s career was a relatively short one. A few years ago, she had lost unexpectedly at the regional championship—a performance attributed to a developing injury in her lower back. Beecroft’s medical team had advised her to skip the regional championships, but she insisted on competing. A few weeks after the competition, Beecroft was admitted with complaints of severe lower back pain causing difficulties in her routine maneuver. She was initially managed by physical therapy; however, she was not getting better. Finally, Beecroft was admitted to the Pain Specialist Clinic five weeks postinjury for throbbing, lower mid-back pain (rated 9/10 on a numeric rating scale) not relieved with acetaminophen. She was given a 2-week supply of Percocet. Despite a proper pain assessment and two follow-up visits, Beecroft continued to have persistent back pain and remained on Percocet. Four months later, she was presented to the emergency room (ER) with sudden lower abdominal cramping (rated 10/10 on a numeric rating scale) aggravated with walking, nausea, and vomiting. On clinical querying, she admitted: “I have not been able to have a bowel movement for a week and when I do have a bowel movement, it is very hard, like little marbles.”
INTRODUCTION
The different multidimensional approach to assessing pain in the older population emphasizes onset, duration, temporal pattern, alleviating factors, aggravating factors, associated symptoms, severity, and quality. Depending on the nature of the pain and health condition of the patients, the practice of using pain scales primarily for assessment has also gained notorious popularity in the global medical community. Pain management, on the other hand, requires an interdisciplinary approach. To a large extent, the nature and quality of pain are the principal factors guiding the design of an effective pain management plan. Opioids are predominantly employed as a symptomatic management option. Depending on drug pharmacokinetics, other analgesics may also be included in the management plan. Drugs like fentanyl, if indicated, may be administered through the transdermal route. Corticosteroids and anti- inflammatory agents are also popularly referenced in different pain management modules. She complained of increased agitation and episodes of crying and feelings of anxiety over the last three months. Imaging and radiographs show fecal impaction. The fecal mass is broken up with digital examination and enema. Preliminary diagnosis in addition to her lower back pain was anxiety and constipation. She is discharged from the ER with a prescription for alprazolam and docusate sodium. Instructions are given to follow up with a primary care provider (PCP) within 2 weeks. On a follow-up visit, the PCP completed a comprehensive primary care assessment of Beecroft’s case. On clinical querying and examination, she complained of dull, lower- back pain bilaterally (rated 6/10 on a numeric rating scale) without radiation. This pain started a few months ago after lifting greater than 50 pounds at the state weightlifting competition. She delayed seeing a PCP for 2 months and has been managed on 14 days of Percocet 5 mg. She has pain on most days (rated 4–6/10 on a numeric rating scale), worse in the morning. She denies fevers and swollen or tender joints in hands, wrists, shoulders, knees, or ankles and denies numbness or tingling in extremities. She continues to take Percocet (10 mg), taking one every 4 to 5 hours as needed on average 5 days a week with some relief. She denies a history of drug abuse, smoking, and alcohol consumption, but she complains of feeling down the past few months and decreased sleep state and pain interfere with doing house chores. She has only taken alprazolam twice in the past month and does not like to take it due to a “loopy feeling.” Recently she gained about 7 pounds in weight, and she spends most of her time at home, denies social activities,
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