135 Evidence Based Implicit Bias Implications for Physicians and Healthcare Professionals
Self-awareness With knowledge of the development and process of implicit bias as a founda- tion, a pause- and-reflect approach can increase the occasions when providers deliberately take a few moments to reflect on their thoughts and behaviors when in- teracting with a patient and/or making an important decision. Pausing allows for a few seconds to reflect on the kinds of associations that they may be making as the patient walks through the door based on the way they’re dressed, their gender, their race, or any other characteristic. Discovering personal tendencies or be- coming aware of an area of personal bias can help in modifying communication, where necessary. Such self-awareness can prompt providers to focus on seeing a given patient as an individual (individu- ation) and trying to see things from the patient’s perspective (perspective taking) . Organization systems and processes Implicit bias can play a key role in fos- tering and reinforcing systems of inequi- ties in hiring and promotion. Race, gen- der, accent, weight, etc. are factors that not only impact implicit bias in patient care but can also influence hiring and pro - motion decisions. Mitigating unconscious bias in rewards and recognition, as well as in selection decisions, is of critical impor- tance in the work to increase the diversi- ty of medical students, clinical providers, researchers, managers, and senior health- care providers. Cues and reminders Information about implicit bias as well as motivation to reflect on personal bi - ases can begin to fade months and even weeks after the initial intervention. Strat- egies to stimulate recall or remind pro- viders about the work to mitigate implicit bias can be useful. Key words or phrases
on the treatment room computer screen or even a specially designed screen sav- er can be used as a reminder. A mobile phone background can contain a photo or a word that serves as a reminder ev- ery time the provider uses the phone. Changing the photo or word periodically can help to avoid habituation. The inside cover of a folder containing CVs can list key phrases to remind search committee members to avoid bias in the screening process. Disparities in access to and delivery of healthcare services As it is quite apparent that disparities in healthcare exist, The Department of Health and Human Services intends to di- rectly address this inequality by 2026. It has posted a draft of its strategic goals for the fiscal years 2022-2026, and impar - tial access to healthcare is of particular interest. The first of the five stated goals is to “Protect and Strengthen Equitable Access to High Quality and Affordable Healthcare” (HHS.gov, 2021a). As part of this goal, one strategic objective specifies an intent to “expand equitable access to comprehensive, community-based, innovative, and culturally-competent healthcare services while addressing so- cial determinants of health”. They de- scribe improved access to health-related services for an underserved population through the removal of barriers to ac- cess, a reduction in disparities in health- care, and support of community-based services. An increase in healthcare fa- cilities, a more diverse healthcare work- force, and collaboration with cultural and community services can all contribute to improvements in access disparities (HHS. gov, 2021b). Chin et al provided specific suggestions for community involvement through school- based care, household
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