OPINION
DOCTORS' Lounge
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insistence on having some pathology: all
of these things factor into decision-making
that could help or harm him.
These are not even major biases, these
are simply the little biases that affect ev-
erything we do. We all have racial, ethnic,
status, community, political, and religious
biases. We have biases about how other
people have raised their children. We have
a tendency to attribute motivation or to
extend understanding based on our bias-
es. But physicians face a real peril in not
acknowledging our own biases and trying
to be aware of them as much as possible.
Jake Miller wrote in the winter 2017
issue of Harvard Medicine all about these
problems as they affect doctors. Studies have
shown that physicians with racial biases are
less likely to treat the nonwhite person’s
pain adequately, and are less likely to offer
the nonwhite person with a heart attack the
clot dissolving treatment. Male physicians
are more likely to offer male patients pain
medicine and female patients who complain
of pain, sedatives. A 2003 study commis-
sioned in 1999 by the Congress to the Na-
tional Academy of Medicine concluded that,
“Racial and ethnic disparities in health care
are consistent and extensive across a range
of medical conditions and services. They are
associated with worse health outcomes and
occur independently of insurance status,
income and education.”
He wrote about two experimental psy-
chologists, Professor Mahzarin Banaji of
Harvard, and Professor Anthony Greenwald
of the University of Washington, who have
together developed the Implicit Association
Test (IAT). This was offered for 10 years
as a separate course for Harvard medical
students in understanding inner biases, and
since 2009 has been integrated into the col-
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LOUISVILLE MEDICINE
lective curriculum there. Their 2013 book
Blindspot explains their work from the 1990s
onward. Their test “measures attitudes and
beliefs that you may be unwilling or unable
to report, or may show that you have an
implicit bias that you had not realized you
had.” Project Implicit has numerous ver-
sions of the IAT that you can take yourself,
online. These include the Skin-tone IAT,
the Arab-Muslim IAT, the Asian IAT, as
well as those for disability, gender-science,
religion, native, age, gender-career, weight,
and sexuality. Go to Project Implicit at awareness of bias and social justice which
specifically integrates race consciousness
into every aspect of medical care is vital.
It is not just politically or socially correct,
it is medically and scientifically correct, in
order to understand all the intersecting
origins of the patient’s problem. He dis-
cusses a teen with asthma who ends up in
the ER all summer, not because h