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Posted: February 10th, 2019
An Implicit Healthcare Bias
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A lifetime of communication and experiences shapes our society’s views and judgements of others throughout so many aspects of our lives. Women have had to power through many misconceptions throughout the year due to experiences that have shaped others views of them to be negetive. Women equality in mainly politics Women have for centuries been making great strides to be seen as equals, thankfully due to these efforts it is evident women’s equality has advanced greatly in many aspects. However, in 2019 we are still seeing a divide between men and women in how they are treated in the healthcare system. Recently, it has been found that there is a bias in the way the general public and medical professionals treat women in dire situations. From many studies finding that women are less likely than men to be treated by bystanders to perform CPR to the treating female critical care patients , a great difference in the quality of treatment has been observed between genders. Why is there such a gap in the way women are treated in such dire situations? It is crucial to draw attention to the unfairness at play. Why is it that the level of treatment is placed at a greater interest of that of males. For instance, “In a large variety of conditions, such as coronary artery disease, Parkinson’s disease, irritable bowel syndrome, neck pain, knee joint arthrosis and tuberculosis, men are investigated and treated more extensively than women with the same severity of symptoms.” says Katarina Hamberg in her online article of gender bias in medicine.What justifies that males deserve this type of care as opposed to women? Many view such a dilemma as a purposeful discrimination of women and favoritism towards men. More importantly, what does that say about those who give it to them. We’ve evolved from the times that personified women remain at home in charge of household. Women seen as uneducated and of less, incapable to vote or provided with the opportunity to gain an education. Women who were unfit in combat or to express to the world their thoughts of mind. They say times have changed but who truly agrees with that statement. Just by focusing in on a factor of our daily lives, medical care, we prove it wrong. Men given a stronger condition than women, is outrageous.
In spite of those common preconceptions, some believe there has been a great advance in women equality and only some remain with such sexist views that it clouds there emotions when trying to act upon a need. Recently, it has been theorized the reason there is such a delay from reaction time when its a women is because of a implicit bias. “Thoughts and feelings are “implicit” if we are unaware of them or mistaken about their nature. We have a bias when, rather than being neutral, we have a preference for (or aversion to) a person or group of people.” (Perception Institute) This meaning, that it is not an intentional bias in healthcare. “… we use the term “implicit bias” to describe when we have attitudes towards people or associate stereotypes with them without our conscious knowledge.” (Perception Institute) This form of a bias has erupted and many studies have been performed in many different fields to see the effects of it on individual’s lives. Ohio State University is one of the many colleges who have dived deeper into the topic. They state there are a few characteristics of implicit bias.” This being, Everyone has an implicit bias. This being even those who should keep a neutral position, such as medical physicians. With this being said, this bias has a strong holding in Women’s healthcare because its a common bias that everyone holds and even with the best in mind end up treating female patients differently. “The implicit associations we hold do not necessarily align with our declared beliefs or even reflect stances we would explicitly endorse. We generally tend to hold implicit biases that favor our own ingroup, though research has shown that we can still hold implicit biases against our ingroup.Implicit biases are malleable. Our brains are incredibly complex, and the implicit associations that we have formed can be gradually unlearned through a variety of debiasing techniques.” (Ohio State University)
However, there are major gender differences in diagnosis and treatment methods that are also found in studies of the medical management of males and females. In situations where the patient’s behavior and the interaction between patient and doctor are controlled there are still evidence of a bias. In such studies, it is hard to explain the differences in terms other than gender bias as a result physicians’ lack of awareness about gender, stereotyped expectations about health and needs in men and women, or a routine-like application of statistical sex or gender differences on individual patients. The roots of gender bias in clinical work might also be found at a system level, which is to say in the healthcare organization or routines, or in distorted content in established medical knowledge.
This bias in no way means that a patient should not expect to receive a lower standard of care because of their gender However, implicit bias may influence the staffs judgement resulting in different treatment. Implicit biases manifest in our non-verbal behaviour towards the people surrounding us. These behaviors can include eye contact, physical acts such as their proximity to a patient. Implicit biases explain a potential dissociation between what a person explicitly believes and wants to do which is treat every patient equally and the hidden influence of negative implicit associations on her thoughts and action. “Gender blindness and stereotyped preconceptions about men and women are identified as key causes to gender bias. However, exaggeration of observed sex and gender differences can also lead to bias.” Looking beyond gender blindness and probing into the awareness of gender in research, implies posing new and critical questions and scrutinizing concepts generally taken for granted.
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Although more knowledge is crucial to eradicate mistreatment and bias as a result of gender blindness and ignorance, availability of facts and information is no safeguard against bias. Despite the many publications about gender bias in treatment and investigations of cardiovascular diseases, inappropriate treatment of women is regularly reported even today. Furthermore, once we learn about differences between populations of men and women a new kind of risk occurs on the individual level, the risk of ‘knowledge-mediated bias’. For instance, it is well known that hypothyreosis is less common in men than women. Thus, the risk that physicians fail to investigate thyroxine levels is greater in male than in female patients, when patients complain of tiredness, loss of energy, constipation or other vague symptoms.
Our findings highlight the need for the healthcare profession to address the role of implicit biases in disparities in healthcare. In addition to addressing implicit biases, measures need to be taken to raise awareness of the potential conflict between holding negative explicit attitudes towards some patient characteristics, such as obesity, and committing to a norm to treat all patients equally. Our review reveals that this is an area in need of more uniform methods of research to enable better comparison and communication between researchers interested in different forms of bias. Important avenues for further research include examination of the interactions between patient characteristics, and between healthcare professional and patient characteristics, and of possible ways in which to tackle the presence of implicit biases in healthcare.
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