Numerous studies highlight the existence of “differentiated care.” In practical terms, this refers to differences in the management of patients who exhibit a distinguishing characteristic, without, in theory, affecting the prognosis.
Implicit biases can play a major role in decision-making, leading to disparities in care that are not medically justified.
The research center Child Trends in the United States, through a study, revealed a striking example of the consequences of implicit bias in healthcare: Black women face higher maternal mortality rates than white women.
While healthcare professionals are expected to treat all patients without distinction, it is naive to think that certain characteristics will not unconsciously influence caregivers. To ensure the safety of care, it is therefore essential to understand implicit biases in order to address them. Implicit biases: definition. The concept of implicit biases is based on the idea that human thought is partly founded on associations. These associations are more or less automatic and unconscious. These associations can be harmful to patients when they concern a personal characteristic such as skin color, ethnicity, weight, religion, gender, sexual orientation, and many others. While the explanations for these associations (racism, sexism, fatphobia, homophobia, etc.) must be vigorously challenged, implicit associations are more complex to understand. Implicit biases operate at a subconscious level and manifest in the attitudes and behaviors of individuals who unconsciously behave differently when interacting with people based on their (unconscious) prejudices. These unconscious behaviors can relate to certain identified or identifiable "categories" of people, either because they are the target of negative social representations or because they represent significant experiences. *
A protocol will be explained in less detail to a person with an intellectual disability because they wouldn't understand it anyway.
An overweight person will have a harder time following a protocol because they are already unable to manage their diet.
A Black person is, on the face of it, less likely to follow hygiene rules. A homosexual person is more likely to transmit a disease to you.
Here are some examples of behaviors that might be observed.
In healthcare, implicit biases can have detrimental effects on how patients are treated by healthcare professionals, even though these professionals are generally committed to treating all patients regardless of their financial resources.
These effects can occur at every stage of the care process and in every aspect of patient management: examination, diagnosis, treatment selection, communication style, therapeutic advice and education, etc. Patients are not the only victims of implicit bias. In fact, healthcare professionals must also confront these unconscious biases in their daily work. A foreign doctor is necessarily less well-trained than a French doctor… A woman and a man enter a patient’s room: she is a nurse and he is a doctor…
Regarding sexist biases in hospitals, 85% of female doctors report having felt discriminated against because of their gender during their professional careers, and 8 out of 10 female doctors admit to having already been victims of sexist behavior.*
Understanding Implicit Biases with the SafeTeam Academy
Although implicit biases operate unconsciously, there are strategies for understanding them:
- We all have implicit biases. Recognizing and accepting this weakness is the first step toward minimizing them as much as possible.
To learn about your implicit biases, take this great test developed at Harvard.
This test is very interesting: it draws on both modes of cognitive functioning—System 1 and System 2—as described by Amos Tversky and Daniel Kahneman (Nobel Prize in Economics). We won't say any more…
- Treat patients as individuals rather than viewing them as part of a group.
- Accept oversight from others by prioritizing third-party verification and secure communication.
Develop metacognition. This involves developing your own critical thinking by regularly and carefully examining your thoughts: Why do I think this? What sources can I rely on? What would another person think? etc. It is in this spirit that the SafeTeam Academy decided to address this sensitive yet fundamental topic, which is unfortunately often overlooked by healthcare professionals and absent from initial healthcare training programs. Methods for reducing bias exist (secure communication, cross-checking, team decision-making, etc.) and are regularly covered in our training programs. We were committed to addressing the issue of implicit bias in healthcare because sexist prejudices still persist. To combat sexism in healthcare, the SafeTeam Academy recently signed the Women in Healthcare charter.
Femmes de Santé is a collective whose mission is to highlight and foster the human element at the heart of the healthcare system and to promote the expertise and initiatives of women in the healthcare sector.
If you found this article interesting, disturbing, or would like to learn more, please contact us at the following address: contact@safeteam.academy
