Overcoming our biases requires understanding how we think – Commercial Appeal

The Trayvon Martin and George Zimmerman case has once again opened the racial wounds of our nation, and it reminded me of the first piece I wrote for The Washington Post six years ago.

I wrote about racial disparity in the health care system, titled “How I Learned to Treat My Bias.” Last week, I read it aloud to my son and daughter. Here are some excerpts:

“I observed myself whenever I entered a hospital room to see a new patient. To my surprise, I realized that in the initial glance I viewed patients as an ‘elderly black man’ or a ‘Hispanic worker’ — and all the baggage that comes with their race, gender and ethnicity. My prejudices had kicked in.

“Unfortunately, the entire health system sees patients by race, gender and ethnicity, and it has a profound effect on how care is delivered.

“The Institute of Medicine in its 2002 report ‘Unequal Treatment’ cited some provocative statistics. Black patients, for example, tend to receive lower-quality care for cancer, heart disease, HIV, diabetes and other illnesses. Black men are 40 percent more likely to die of cancer than white men. These differences often persist even after accounting for age, severity of illness and delays in seeking treatment among different groups.

“How can this happen in America in 2007? It’s simple. Social psychology shows that stereotyping is a universal human mental function. We use social groups (race, sex and ethnicity) to understand people — to gather or recall information about people from our minds.

“The mental processing goes something like this:

“When I enter the room in which a patient is waiting for me, I do four things.

“First, in the seconds before our initial greeting, I automatically and often unconsciously activate my stereotype. Thus, I assume a young Hispanic man is likely to be an uninsured construction worker.

“Second, even though I believe that I do not judge people based on stereotypes, the data show it is very likely that I do. When I see an elderly black woman I am more likely to ask her about church as a support structure than I am to ask a white man the same question because I assume she is churchgoing.

“Third, after the encounter, my stereotyping affects how I recall and process information. A white man complaining of pain receives more attention than a Hispanic woman with the same complaint because I stereotype white men as being more stoic.

“Fourth, my stereotypes probably guide my expectations and handling of the patient, resulting in a self-fulfilling prophecy. An elderly black man is unlikely to understand the details of a diagnosis, I assume, so I spend less time explaining his disease and its consequences. Ultimately, such a patient is less informed about his illness.

“The most glaring result of black-white inequality in health care was found in a 2005 study issued by former surgeon general David Satcher. He estimated that closing the black-white mortality gap would eliminate more than 83,000 deaths per year among African Americans.

“It is painful to write these things. As health care workers we try to be unbiased in our delivery of care.”

So what is the solution? If we wish to overcome the unintended racial disparities, we need to become aware of how we think. Then we need to force our reflections and judgments beyond the stereotype before that encounter. Almost every time, I notice, after I engage in a conversation with a patient, the stereotype melts away, and I see the patient as person, not their stereotypical social group.

I told my children I hope my patients do the same for me. I hope that they do not see me only as a brown foreigner but recognize me as a doctor keen to be a partner in their health care.

Source : Commercial Appeal