5 - Physician Bias

Question 1

Define implicit bias

Answer 1

• Within your own head, something you have formulated
• NOT always aware of it
• I say that I really like a type of person and don’t think I have a bias, but in reality, I treat them differently
• You act differently, even though you think you don’t
• You try to control your bias or you might not even know you have that bias
• Until we reflect on this bias, we may not recognize it

Question 2

Define explicit bias

Answer 2

• I do NOT like a certain group of people and I am verbal about it
• I am aware of it and I know that it influences actions and decisions

Question 3

Microaggressions

Answer 3

Microaggressions are the everyday verbal, nonverbal, and environmental slights, snubs, or insults, whether intentional or
unintentional, that communicate hostile, derogatory, or negative messages to target persons based solely upon their
marginalized group
membership

Question 4

Describe stereotypes in relation to physician bias

Answer 4

• Sterotypes are well-learned sets of associations
• This stereotype may be accurate at a group level, but inaccurate at an individual level
• Common cultural experiences create awareness of stereotypes
• These can be automatically activated in ways that bypass deliberate thought and influence judgment
• Simply knowing about a stereotype can lead to distorting of the processing of info about individuals

Question 5

What aspects of person can be stereotyped or cause a physician bias?

Answer 5

• Age
• Obesity
• Race
• Sex
• Religion
• Sexual Orientation
• Class
• Disability

What happens if these are combined?

Question 6

What have various studies found in relation to implicit bias?

Answer 6

• TKA- Men over women same age, health, disease
• Hispanics- less analgesia in the ER compared to non-hispanics (adjusted for confounders)
• Physicians could accurately judge level of pain regardless of ethnicity
• Blacks- significantly less likely to receive pain meds in ER

Question 7

Describe the impact of perception?

Answer 7

Physicians with low explicit bias, high implicit bias:

• How where they perceived by patients?
• How will this impact care?
• How do you think they rated compared to those with high explicit and high implicit bias? And low explicit and implicit bias?

Those with explicit bias were actually rated higher than those with a really high implicit bias - patients can see through this and if you are not aware of it, you cannot manage it

Question 8

Describe awareness

Answer 8

• Conceptualizing as a “habit of mind”
• Individuating: conscious effort to focus on specific info about the individual
• Makes it more important for the decision then the persons social category
• Perspective- Taking: conscious effort to envision another persons point of view

Question 9

Describe a study on pain medications

Answer 9

• Nurses told to use best judgment for pain medication for white or black patients = LESS pain meds for blacks
• Nurses instructed to imagine how the patient felt = SAME amount of pain meds for blacks

This is because when you are forced to consider each patient individually and decide accordingly

Question 10

What do you need to study in terms of diagnosis bias?

Answer 10

• Multiple forms like implicit bias, awareness is key to preventing

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