Speaker 1: Welcome to brain Stuff, a production of I Heart Radio.
Speaker 1: Hey brain Stuff Lauren Bogle Bam here, and this is
Speaker 1: a classic episode from our archives. This one goes into
Speaker 1: unconscious biases. We all have them, and many of us
Speaker 1: are working on them. But what happens when our doctors
Speaker 1: have them? Hey brain Stuff Lauren Vogelbaum here. Years of
Speaker 1: playing basketball had given Damon Tweetie some bum knees. When
Speaker 1: the swelling didn't go down on his left knee after
Speaker 1: a few days, he went to an urgent care clinic
Speaker 1: for treatment. It was his day off and he was
Speaker 1: dressed in a T shirt and sweatpants. He remembers the
Speaker 1: doctor never looked at me. He just had me stand up,
Speaker 1: looked at my knees, and then said you'll be okay,
Speaker 1: take it easy. He never even asked what kind of
Speaker 1: job I had? What if Tweete's job required a lot
Speaker 1: of moving around in a way it did. Damon Tweetie
Speaker 1: is a doctor himself, and once he made that clear
Speaker 1: to the physician who was treating him, everything changed. The
Speaker 1: doctor made eye contact and started asking him questions. He
Speaker 1: even took Tweetie to get an X ray. Tweety said,
Speaker 1: so it was an example of two different levels of care.
Speaker 1: I was two different people. First time, I was Damon Tweety,
Speaker 1: random black guy not to be taken seriously. In the
Speaker 1: second case, I was Damon tweet E m d. And
Speaker 1: worthy of the same care as anyone else. Tweety told
Speaker 1: his story at the Decatur Book Festival in Georgia and
Speaker 1: has written a book that is part memoir and part
Speaker 1: discussion of bias and medicine, called black Man in a
Speaker 1: White Coat. Not every medical misstep has to do with
Speaker 1: the accidental slip of a scalpel or a medication dosing error.
Speaker 1: The unconscious biases that everyone possesses to one degree or
Speaker 1: another can impact how a doctor cares for a patient.
Speaker 1: Wholly separate from personally accepted prejudices like overt racism or homophobia.
Speaker 1: Unconscious biases are just that, biases that we don't even
Speaker 1: know we have yet can impact how we treat others.
Speaker 1: We also spoke with Renee Salazar, m d. A professor
Speaker 1: of clinical medicine and the Director of Diversity in the
Speaker 1: Department of Medicine at the University of California, San Francisco.
Speaker 1: She put it this way, They're so deep within our
Speaker 1: psyche that we're unaware of their existence, and we spoke
Speaker 1: with Gordon Wallace, m d. Of the Canadian Medical Protective
Speaker 1: Association via email. He explained that cognitive biases, or distortions
Speaker 1: of thinking, are hardwired functions of the human brain, and
Speaker 1: they can occasionally interfere with a doctor's ability to reach
Speaker 1: a correct diagnosis. Racial bias is probably the most commonly
Speaker 1: studied type. However, it's possible to harbor unconscious biases against
Speaker 1: all kinds of people do for example, to their body weight, gender,
Speaker 1: or sexual orientation. Cognitive bias isn't as obvious or easy
Speaker 1: to pinpoint in a clinical setting because it isn't intentional.
Speaker 1: Many studies have been conducted to determine whether or not
Speaker 1: doctors possess unconscious biases, but one published in the Journal
Speaker 1: of Internal Medicine took it a step further to measure
Speaker 1: how these biases would actually affect treatment. In study, physicians
Speaker 1: using an online tool were presented with randomized black and
Speaker 1: white patients showing signs of coronary artery disease. The doctors
Speaker 1: assessed to the patients and recommended a course of treatment
Speaker 1: for each, but the results showed that doctors more often
Speaker 1: suggested thrombolosis, a treatment to break up blood clots to
Speaker 1: the white patients, while the black patients were left with
Speaker 1: less aggressive options. The researchers drew the conclusion that unconscious
Speaker 1: biases can impact the types of treatments prescribed to patients
Speaker 1: even when they present the same symptoms as others. So
Speaker 1: if doctors are completely unaware of their biases, how can
Speaker 1: they possibly change their patient care strategies. Many turned to
Speaker 1: the Implicit Association Test, a respected tool that assesses and
Speaker 1: reports on unconscious bias. Dr Salazar said, what we find
Speaker 1: most often is there's a disconnect between what people explicitly
Speaker 1: feel and what they feel unconsciously. Once the results are available,
Speaker 1: it's easier to be aware of personal cognitive biases and
Speaker 1: take steps to minimize them. Manydical schools and hospitals are
Speaker 1: establishing curricula to better train doctors on how to avoid
Speaker 1: the pitfalls of cognitive bias, offering seminars and encouraging the
Speaker 1: use of the I a T assessment tool. The Canadian
Speaker 1: Medical Protective Association also backs up recommendations by expert Dr
Speaker 1: pat cross Carry, an emergency physician and psychologist at Dalhousie
Speaker 1: University in Halifax, Nova Scotia. Cross Carry suggests group decision
Speaker 1: making and consultation, and the use of mindful reflection and
Speaker 1: slowing down strategies to help the doctor deliberately transition from
Speaker 1: intuitive a k a. Biased thinking to a more analytic mode.
Speaker 1: Following checklists and computerized decision support systems also helped to
Speaker 1: remove the human element, and experts suggest abiding by general
Speaker 1: rules of thumb to avoid bias impact. For example, anyone
Speaker 1: exhibiting specific neurological symptoms should always have their blood sugar tested.
Speaker 1: Self awareness is also key to avoiding medical bias. Salazar explains,
Speaker 1: just by knowing that these biases are there, we can
Speaker 1: really take steps to reduce the impact. Let me stop
Speaker 1: that process right now and make sure that I go
Speaker 1: in with a clean slate and provide care with as
Speaker 1: open a mind as possible. From a patient perspective, It's
Speaker 1: not always going to be easy to figure out if
Speaker 1: a medical provider is unconsciously biased against you or a
Speaker 1: family member. To avoid being swept under the rug, ask
Speaker 1: questions and document the answers, and never be afraid to
Speaker 1: request an additional opinion or consult Doctors aren't the only
Speaker 1: people who experience unconscious bias. You can take an implicit
Speaker 1: association test online at implicit dot Harvard dot edu to
Speaker 1: find out your true opinions on a variety of issues
Speaker 1: including sexual orientation, race, and gender. The results could help
Speaker 1: you identify areas where you might benefit from being more intentional, which,
Speaker 1: let's face it, we've all got a few up. Today's
Speaker 1: episode is based on the article how do doctor's biases
Speaker 1: affect your health Care? On how stuff works dot com,
Speaker 1: written by a Ahoy. Brain Stuff is production by Heart
Speaker 1: Radio in partnership with how stuffworks dot com, and it's
Speaker 1: produced by Tyler Playing. For more podcasts from my heart Radio,
Speaker 1: visit the i heart Radio app, Apple Podcasts, or wherever
Speaker 1: you listen to your favorite shows.