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.
regardless of their race, ethnicity, or other characteristics. Cultural competence and empathy training can significantly address these biases and improve healthcare delivery. Before we take a deep dive into biases, let’s look at a scenario. Meet our characters: ● Dr. Sarai Hadley: a physician, 15 years of experience ● Mr. Rick Michaels: a patient, 53-year-old black male ● Leslie: Dr. Hadley’s nurse Scenario: Dr. Hadley walked into her clinic, ready for another busy day of seeing patients. As she reviewed her schedule, she noticed Mr. Rick Michaels, a 53-year-old black man, was coming in for a follow-up appointment. He had been complaining of persistent abdominal pain and fatigue for the past few months. Dr. Hadley had seen Mr. Michaels a few times before, but his symptoms were rather vague and non-specific. She remembered that his blood tests and imaging results had been within the normal range during previous visits, so she dismissed his symptoms as likely caused by stress or a minor digestive issue. However, today, Mr. Michaels looked visibly more fatigued and seemed to be in more pain. As he entered the examination room, Nurse Leslie greeted him warmly and recorded his vital signs. Dr. Hadley followed shortly after, and after some small talk, she asked Mr. Michaels to explain his symptoms again. He hesitated slightly before describing his symptoms, feeling like his concerns had been brushed off in the past. Nevertheless, he detailed the persistence of his abdominal pain, which had started interfering with his daily activities, and how he felt unusually fatigued despite getting enough rest. Dr. Hadley listened attentively but found herself feeling unconsciously biased. She considered the possibility of Mr. Michaels exaggerating his symptoms or seeking pain medication for reasons other than genuine medical needs. As Mr. Michaels spoke, Dr. Hadley’s implicit bias influenced her clinical judgment, leading her to attribute his symptoms to less severe conditions, potentially ignoring serious underlying issues. She decided to order a few more blood tests and an ultrasound, primarily to appease Mr. Michaels, rather than out of genuine concern for his well-being. A few days later, the test results came back, and Nurse Leslie brought them to Dr. Hadley’s attention. Although the results showed some abnormalities, she subconsciously dismissed them as minor anomalies that wouldn't account for the symptoms. She prescribed him some over-the- counter pain relief medication and advised him to return if the pain persisted. 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.
DEVELOPMENT OF BIASES
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
Video: Recognizing, Combatting, and Addressing Implicit Bias
EliteLearning.com/Massage-Therapy
Book Code: MMD0926
Page 50
Powered by FlippingBook