Welcome to brain Stuff, a production of I Heart Radio. Hey brain Stuff Lauren Bogle Bam here, and this is a classic episode from our archives. This one goes into unconscious biases. We all have them, and many of us are working on them. But what happens when our doctors have them? Hey brain Stuff Lauren Vogelbaum here. Years of playing basketball had given Damon Tweetie some bum knees. When the swelling didn't go down on his left knee after a few days, he went to an urgent care clinic
for treatment. It was his day off and he was dressed in a T shirt and sweatpants. He remembers the doctor never looked at me. He just had me stand up, looked at my knees, and then said you'll be okay, take it easy. He never even asked what kind of job I had? What if Tweete's job required a lot of moving around in a way it did. Damon Tweetie is a doctor himself, and once he made that clear to the physician who was treating him, everything changed. The
doctor made eye contact and started asking him questions. He even took Tweetie to get an X ray. Tweety said, so it was an example of two different levels of care. I was two different people. First time, I was Damon Tweety, random black guy not to be taken seriously. In the second case, I was Damon tweet E m d. And
worthy of the same care as anyone else. Tweety told his story at the Decatur Book Festival in Georgia and has written a book that is part memoir and part discussion of bias and medicine, called black Man in a White Coat. Not every medical misstep has to do with the accidental slip of a scalpel or a medication dosing error. The unconscious biases that everyone possesses to one degree or another can impact how a doctor cares for a patient.
Wholly separate from personally accepted prejudices like overt racism or homophobia. Unconscious biases are just that, biases that we don't even know we have yet can impact how we treat others. We also spoke with Renee Salazar, m d. A professor of clinical medicine and the Director of Diversity in the Department of Medicine at the University of California, San Francisco.
She put it this way, They're so deep within our psyche that we're unaware of their existence, and we spoke with Gordon Wallace, m d. Of the Canadian Medical Protective Association via email. He explained that cognitive biases, or distortions of thinking, are hardwired functions of the human brain, and they can occasionally interfere with a doctor's ability to reach a correct diagnosis. Racial bias is probably the most commonly
studied type. However, it's possible to harbor unconscious biases against all kinds of people do for example, to their body weight, gender, or sexual orientation. Cognitive bias isn't as obvious or easy to pinpoint in a clinical setting because it isn't intentional. Many studies have been conducted to determine whether or not doctors possess unconscious biases, but one published in the Journal of Internal Medicine took it a step further to measure
how these biases would actually affect treatment. In study, physicians using an online tool were presented with randomized black and white patients showing signs of coronary artery disease. The doctors assessed to the patients and recommended a course of treatment for each, but the results showed that doctors more often suggested thrombolosis, a treatment to break up blood clots to the white patients, while the black patients were left with
less aggressive options. The researchers drew the conclusion that unconscious biases can impact the types of treatments prescribed to patients even when they present the same symptoms as others. So if doctors are completely unaware of their biases, how can they possibly change their patient care strategies. Many turned to the Implicit Association Test, a respected tool that assesses and
reports on unconscious bias. Dr Salazar said, what we find most often is there's a disconnect between what people explicitly feel and what they feel unconsciously. Once the results are available, it's easier to be aware of personal cognitive biases and take steps to minimize them. Manydical schools and hospitals are establishing curricula to better train doctors on how to avoid the pitfalls of cognitive bias, offering seminars and encouraging the
use of the I a T assessment tool. The Canadian Medical Protective Association also backs up recommendations by expert Dr pat cross Carry, an emergency physician and psychologist at Dalhousie University in Halifax, Nova Scotia. Cross Carry suggests group decision making and consultation, and the use of mindful reflection and slowing down strategies to help the doctor deliberately transition from intuitive a k a. Biased thinking to a more analytic mode.
Following checklists and computerized decision support systems also helped to remove the human element, and experts suggest abiding by general rules of thumb to avoid bias impact. For example, anyone exhibiting specific neurological symptoms should always have their blood sugar tested. Self awareness is also key to avoiding medical bias. Salazar explains, just by knowing that these biases are there, we can
really take steps to reduce the impact. Let me stop that process right now and make sure that I go in with a clean slate and provide care with as open a mind as possible. From a patient perspective, It's not always going to be easy to figure out if a medical provider is unconsciously biased against you or a family member. To avoid being swept under the rug, ask questions and document the answers, and never be afraid to request an additional opinion or consult Doctors aren't the only
people who experience unconscious bias. You can take an implicit association test online at implicit dot Harvard dot edu to find out your true opinions on a variety of issues including sexual orientation, race, and gender. The results could help you identify areas where you might benefit from being more intentional, which, let's face it, we've all got a few up. Today's episode is based on the article how do doctor's biases affect your health Care? On how stuff works dot com,
written by a Ahoy. Brain Stuff is production by Heart Radio in partnership with how stuffworks dot com, and it's produced by Tyler Playing. For more podcasts from my heart Radio, visit the i heart Radio app, Apple Podcasts, or wherever you listen to your favorite shows.