Over the next few weeks, his symptoms worsened, but he hesitated to return to the clinic, feeling that his concerns were not being taken seriously. Eventually, his condition deteriorated to the point where he had no choice but to visit the emergency department. In the emergency department, a different physician recognized the severity of his symptoms and ordered a more comprehensive set of tests, including a CT scan and a biopsy. The results revealed that Mr. Michaels had advanced-stage colon cancer, which had metastasized to other organs. Due to the delay in diagnosis caused by implicit biases, Mr. Michaels’ cancer had progressed to an advanced stage, significantly reducing his chances of successful treatment and recovery. The missed opportunities to diagnose and treat his condition earlier profoundly impacted his health and well-being. Now let’s take a moment to analyze this scenario. Dr. Hadley responded the way she did due to implicit biases, which are unconscious attitudes or stereotypes that affect our actions and decisions without us being aware of them. Various factors, including cultural norms, personal experiences, media representations, and societal conditioning, can shape implicit biases. There are different types of implicit biases and in this scenario, several biases influenced Dr. Hadley’s response: ● Racial Bias: Dr. Hadley may have unintentionally held stereotypes or assumptions about black patients, leading her to subconsciously perceive their symptoms
as less credible or severe compared to white patients. It is highly probable she didn't take his complaints as seriously as she might have for a patient of a different race. ● Confirmation Bias: Dr. Hadley might have been influenced by confirmation bias, which occurs when someone seeks or interprets information in a way that confirms their preexisting beliefs or assumptions. Since Mr. Michaels had presented with vague and non-specific symptoms before, she may have been inclined to interpret his current complaints in a way that aligned with her previous impression of him, further downplaying the significance of his symptoms. ● Anchoring Bias: Anchoring bias occurs when a person relies too heavily on the first piece of information encountered when making decisions. Dr. Hadley had seen Mr. Michaels before with normal test results, and this initial information might have anchored her thinking, making her less receptive to considering alternative or more serious diagnoses during subsequent visits. ● Gender Bias: Though not explicitly mentioned in the scenario, gender bias could also play a role in Dr. Hadley's response. If she had different attitudes towards male and female patients, it might have influenced how she perceived and responded to Mr. Michaels’ symptoms. Now, let’s take a deeper look into biases, how they develop and how we can mitigate their potential consequences.
DEVELOPMENT OF BIASES
Implicit Bias: A bias you are unaware of that leads to unintentional outcomes such as disparities and inequalities in treatment Explicit Bias: A bias of which you are aware, and the outcomes are intentional in causing disparities and inequalities in treatment. (Witter, 2022) To see an example of how implicit bias can affect career progression, take a few minutes to view this video.
Video: Recognizing, Combatting, and Addressing Implicit Bias
Video: How Implicit Bias Affects Career Progression
It is significant to note that everyone has biases. Biases are not new and are formulated from the surroundings we interact with daily, from family and other people, literature, audio and visual cues, news outlets, and institutions (Greenwald et al., 2022). Researchers suggest that most biases develop between infancy and childhood by favoring the familiar as a protective mechanism. What is familiar is safe, and what is foreign should be assumed to be dangerous until proven otherwise (Cardiology, 2020). How to prevent the development of implicit biases is unknown, as evidence has shown that even in households where parents have nondiscriminatory beliefs and practices, children still passively acquire the perspectives of their society (Greenwald et al., 2022). The term implicit hints at something being indirect, while bias is a prejudice for or against something or someone. Regardless of who we are, for example, our gender, ethnicity, or educational level, we have all experienced the repercussions of implicit bias at some point in our life.
Biases are preconceptions in acceptance of or against, for example, a person, race, gender, weight, or nationality (Norwood, 2022). Most personal biases are subconscious, learned behaviors, beliefs, attitudes, and stereotypes. These unconscious biases significantly affect our decision making in daily interactions. About 90% of the brain’s processing is done unconsciously (i.e., implicit thinking), meaning the brain processes only a relatively small portion of the information it receives consciously, which powers our long-term memory and critical thinking (i.e., explicit
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