Speaker 1: Welcome to brain Stuff from How Stuff Works, Hey, brain
Speaker 1: Stuff Lauren Vogelbaum here. Years of playing basketball had given
Speaker 1: Damon Tweetie some bum knees. When the swelling didn't go
Speaker 1: down on his left knee after a few days, he
Speaker 1: went to an urgent care clinic for treatment. It was
Speaker 1: his day off, and he was dressed in a T
Speaker 1: shirt and sweatpants. He remembers the doctor never looked at me.
Speaker 1: He just had me stand up, looked at my knees,
Speaker 1: and then said, you'll be okay, take it easy. He
Speaker 1: never even asked what kind of job I had. What
Speaker 1: if Tweete's job required a lot of moving around in
Speaker 1: a way it did. Damon Tweetie is a doctor himself,
Speaker 1: and once he made that clear to the physician who
Speaker 1: was treating him, everything changed. The doctor made eye contact
Speaker 1: and started asking him questions. He even took Tweetie to
Speaker 1: get an X ray. Tweet said, so it was an
Speaker 1: example of two different levels of care. I was two
Speaker 1: different people. First time, I was Damon Tweetie, random black
Speaker 1: guy not to be taken seriously. In the second case,
Speaker 1: I was Damon Tweete, m D and worthy of the
Speaker 1: same care as anyone else, tweeted, told his story at
Speaker 1: the Decatur Book Festival in Georgia and has written a
Speaker 1: book that is part memoir and part discussion of bias
Speaker 1: and medicine called black Man in a White Coat. Not
Speaker 1: every medical mistep has to do with the accidental slip
Speaker 1: of a scalpel or a medication dosing error. The unconscious
Speaker 1: biases that everyone possesses, to one degree or another can
Speaker 1: impact how a doctor cares for a patient. Wholly separate
Speaker 1: from personally accepted prejudices like overt racism or homophobia, unconscious
Speaker 1: biases are just that, biases that we don't even know
Speaker 1: we have yet can impact how we treat others. We
Speaker 1: also spoke with Renee Salazar, m d, a professor of
Speaker 1: clinical medicine and the Director of Diversity in the Department
Speaker 1: of Medicine at the University of California, San Francisco. She
Speaker 1: put it this way, they're so deep within our psyche
Speaker 1: that we're unaware of their existence. And we spoke with
Speaker 1: Gordon Wallace, m d. Of the Canadian Medical Protective Association
Speaker 1: via email. He explained that cognitive biases, or distortions of thinking,
Speaker 1: are hardwired functions of the human brain, and they can
Speaker 1: occasionally interfere with a doctor's ability to reach a correct diagnosis.
Speaker 1: Racial bias is probably the most commonly studied type. However,
Speaker 1: it's possible to harbor unconscious biases against all kinds of
Speaker 1: people do for example, to their body weight, gender, or
Speaker 1: sexual orientation. Cognitive bias isn't as obvious or easy to
Speaker 1: pinpoint in a clinical setting because it isn't intentional. Many
Speaker 1: studies have been conducted to determine whether or not doctors
Speaker 1: possess unconscious biases, but one published in the Journal of
Speaker 1: Internal Medicine took it a step further to measure how
Speaker 1: these biases would actually affect treatment. In study, physicians using
Speaker 1: an online tool were presented with randomized black and white
Speaker 1: patients showing signs of coronary artery disease. The doctors assessed
Speaker 1: the patients and recommended a course of treatment for each,
Speaker 1: but the results showed that doctors more often suggested thrombolosis,
Speaker 1: a treatment to break up blood clots, to the white patients,
Speaker 1: while the black patients were left with less aggressive options.
Speaker 1: The researchers drew the conclusion that unconscious biases can impact
Speaker 1: the types of treatments prescribed to patients even when they
Speaker 1: present the same symptoms as others. So if doctors are
Speaker 1: completely unaware of their biases, how can they possibly change
Speaker 1: their patient care strategies. Many turn to the implicit Association test,
Speaker 1: a respected tool that assesses and reports on unconscious bias.
Speaker 1: Dr Salazar said, what we find most often is there's
Speaker 1: a disconnect between what people explicitly feel and what they
Speaker 1: feel unconsciously. Once the results are available, it's easier to
Speaker 1: be aware of personal cognitive biases and take steps to
Speaker 1: minimize them. Many medical schools and hospitals are establishing curricula
Speaker 1: to better train doctors on how to avoid the pitfalls
Speaker 1: of cognitive bias, offering seminars and encouraging the use of
Speaker 1: the I a T assessment tool. The Canadian Medical Protective
Speaker 1: Association also backs up recommendations by expert Dr Pat Crosscerry,
Speaker 1: an emergency physics and psychologist at Dalhousie University in Halifax,
Speaker 1: Nova Scotia. Cross Carey suggests group decision making and consultation,
Speaker 1: and the use of mindful reflection and slowing down strategies
Speaker 1: to help the doctor deliberately transition from intuitive a k
Speaker 1: A biased thinking to a more analytic mode. Following checklists
Speaker 1: and computerized decision support systems also helped to remove the
Speaker 1: human element, and experts suggest abiding by general rules of
Speaker 1: thumb to avoid bias impact. For example, anyone exhibiting specific
Speaker 1: neurological symptoms should always have their blood sugar tested. Self
Speaker 1: 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. Of course, doctors aren't
Speaker 1: the only people who experience unconscious bias. You can take
Speaker 1: an implicit association test online at implicit dot Harvard dot
Speaker 1: a d u slash implicit to find out your true
Speaker 1: opinions on a variety of issues, including sexual orientation, race,
Speaker 1: and gender. The results could help you identify areas where
Speaker 1: you could benefit from being more intentional, which, let's face it,
Speaker 1: we've all got a few of. Today's episode was written
Speaker 1: by Alia Hoyt and produced by Tyler Clang. Brain Stuff
Speaker 1: has merched. Now you can contain your liquids, electronics, and
Speaker 1: or body in brainy style by visiting t public dot
Speaker 1: com slash brain stuff, and, of course, for lots more
Speaker 1: on this and other intentional topics, visit our home planet,
Speaker 1: how stuff works dot com.