COMMENTARY

Implicit Bias: It's in All of Us

Amber L. Robins, MD, MBA

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February 07, 2018

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Hello. My name is Dr Amber Robins. I am a Health and Media Fellow at Georgetown University. I'm here to talk to you about implicit bias. In the medical community, this is something that we're talking about even more. The question is: What is it?

The [Kirwan Institute for the Study of Race and Ethnicity] at The Ohio State University states that implicit bias refers to the attitude or stereotypes that affect our understanding, actions, and decisions in an unconscious manner—which means that we don't know we're doing it. What can we do to help us determine whether we have implicit bias? By the way, all of us have it. So you have it too.

What can we do to change it? You may, as a woman or as a doctor, have come in contact with it. As a woman, I know that a lot of people think that I'm a nurse instead of a doctor. That's a type of implicit bias. Another example of implicit bias is actually something that we do to patients. Studies have shown that African Americans and Hispanic Americans may not get the same type of treatment in regard to pain.[1] They may not get pain medications in a manner similar to those who are not African American or Hispanic.

Thinking about those dynamics, what can we do to, first, decrease health disparities like that and second, do a better job of taking care of our patients, one patient at a time?

These are some recommendations that I give to you:

Address the problem. Number one, address the problem. Accept that all of us have implicit biases. How do we do that? How do we find out? Harvard University has a wonderful website called Project Implicit that looks at implicit bias and tests to see what yours may be. Whether it be race or different cultures, [it assesses our implicit bias] so that we can recognize it and call it out for what it is.

Look at your patients. The second thing that I suggest is to look at your patients, at your coworkers, at the people you meet as individuals. Let them show you who they are. Don't come up with a stereotype or bias that may not be in line with the person that they may be. Each person is different and we should treat them that way.

Step into someone else's shoes. The third thing that I would suggest is to actually take the time to step into your patients' or coworkers' shoes. This is another way that we can improve our implicit bias [that is inherent in our human nature]. That step also can help us improve our skills of empathy and sympathy for people.

Teach. The fourth thing that I would suggest is that all of us, each one, should teach. If you see someone who has an implicit bias, if you see someone who may have some issues with stereotypes, whether good or bad, point it out. In medicine, we have a tendency to continue with stereotypes as time goes on. Many times, I have heard, as you may have, [statements that suggest implicit bias]—statements like, "This type of patient doesn't need pain medication" or "This type of patient should only have this type of blood pressure medication." While [some of these statements may be true based on] physiologic things, we must also look at the individual and recognize that [these kinds of statements] may not necessarily be the case for everyone.

Being courageous and pointing those things out can help us all fight against implicit bias.

These are just some tidbits that I wanted to share with you about the subject. Of course, there are many more things that you can do to help prevent implicit bias. I hope that this video is a good start for you to get rid of that implicit bias as best as you can.

My name is Dr Amber Robins. I look forward to doing even more videos about implicit bias and other topics that may be important to you. Thank you.

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