When discussing topics on racial health disparities and equity in medicine, we sometimes overlook the impact that subconscious bias can have on healthcare delivery. An article in PubMed Central defines implicit bias as the “thoughts and feelings that often exist outside of conscious awareness, and thus are difficult to consciously acknowledge and control.” Implicit bias, in other words, is the unconscious stereotyping of a certain group of people. A way to measure implicit bias is through the Implicit Association Test (IAT), which compares your conscious and subconscious beliefs about certain topics (race, gender-career, etc.). If you wish to take this test and see how it works, you may click here. Implicit bias, though hidden by the subconscious, may be dangerous in settings like healthcare facilities as it negatively impacts patient care.
For example, a study conducted by Lisa A. Cooper, MD revealed that physicians who had higher implicit bias scores controlled the conversation with their patients during appointments more often than physicians who received a lower score. Black patients who experienced this type of treatment from their healthcare providers lowered their trust in physicians and gave a low rating to the care they received. Trust is essential in a doctor-patient relationship as patients may share information that will help a doctor provide better care and they will trust their physician’s treatment plan. Another study published in the Journal of Clinical Oncology involving the relationship between Black cancer patients and their physicians shows that doctors with higher implicit bias scores did not spend as much time with their patients compared to oncologists with lower implicit bias scores. Unfortunately, implicit bias has proven to be deadly as seen during the Covid-19 pandemic. Back in 2020, a New York Times article details stories of Black families who lost their loved ones due to healthcare providers sending these patients home because their symptoms were not taken seriously and believed they did not require further testing, which caused them to eventually pass from the disease.
In order to alleviate these disparities, medical schools should implement coursework that can reduce the impact that implicit bias has on patients of color. For example, the University of Virginia and The University of California–San Francisco School of Medicine have implemented courses for their first-year students that contextualize the relationship between race, implicit bias, and health disparities. However, several studies showed that “student reports of organizational climate, contact with minority faculty and patients, and faculty role-modeling” helped more in changing the students’ implicit bias than curricula. Furthermore, requiring training on implicit bias is imperative to help solve this problem in healthcare. For example, the states of Michigan and California have established new requirements where health care workers have to obtain implicit bias training in order to continue their profession.
