Just as biased physicians cannot provide the best care, biased professionals can’t create and foster environments that maximize productivity.
Learn (from lessons taught to doctors!) how to recognize and confront your unconscious habits.
We live in a world with more diverse representation and leadership in government, industry, education and health care than ever before. Some have even argued that we live in a “post-racial” or “post-gendered” society.
But the fact is, you’re biased. And so am I.
We hear words like bias and think racism. “That’s not me!” we say. What we’re imagining is what researchers call explicit, or conscious, bias. Those are the outward attitudes that come from things we consciously feel and express, and are responsible for many of the “-isms” like racism, sexism and ethnocentrism (measuring others’ cultures against the values and standards of our own).
I’m not talking about those. Instead, I’m interested in our implicit, or unconscious, biases — the attitudes and beliefs I don’t know I have. These biases lead to automatic assumptions, stereotypes and behaviors that can cause very subtle — but real — differences in how I treat or communicate and interact with others.
Unconscious biases are based on much more than race. They can form against any individual or characteristic I perceive as different from me. Research shows that some of today’s most prevalent biases are for people of different religions, gender identities or sexual orientations; those with disabilities; and even the elderly. They impact our relationships with patients, clients, customers, students and colleagues.
But being unaware of these biases doesn’t mean we lack the ability to control them. Here are six ways to understand and address the biases you don’t even know you have, taken from techniques I teach medical students learning to care for patients.
Find the Motivation
The first question to ask yourself is this: What motivates me to try to want to change this pattern? For me, it’s my patients. I know that health disparities exist — that health outcomes are different for patients who are Black, Latinx, gay or transgender. I want to be a better physician, mindful of how my biases inform the decisions I make about treatment.
Your motivation may be to build a more diverse, inclusive office. Or you may want to better serve the needs of your constituents, clients or students. Whatever your motivation, that’s your starting point.
Build Your Awareness
After identifying my motivation, I need to recognize the biases I have. One tool we have for assessing unconscious bias is the Implicit Association Test (IAT). While it’s not without its critics — and though you may be skeptical — with 20 million users in nearly 20 years, there’s a lot of good, rich data.
IATs are offered to assess our attitudes on gender, nationality, racial and ethnic identities, religion, disability, age, skin tone, weight and sexuality. Each (free) test takes about 10 minutes and ends with information about your results and what they might mean.
Normalize & Process
I remember the first time I took an IAT. To learn that I had an automatic and unconscious preference for one group over another was very disturbing to me. I actually took the test two more times to make sure it was right.
It’s important to remember that we’re hard-wired to think this way, and we’re all susceptible to the external messages we get every day. Don’t feel guilty. Instead, work on accepting the idea of unconscious bias, and try to understand what experiences in your life helped contribute to the development of your biases. Don’t let discomfort stop your progress.
Connect With Other Communities
After you’ve identified your biases, a way to begin mitigating them is to make diverse connections. Expand your social world. By making friends of many races, with disabilities, of many sexual orientations and gender identities, you’re building positive associations that work against the unconscious biases you may have developed.
Open Wide (No ‘Aah’ Required)
Be mindful about the messages — visual, verbal, mediated — you receive every day, and consider how they may influence your biases.
Viewing and using positive imagery is a powerful way to counteract the negative external messages that contribute to unconscious bias. Seeing images of a Black president or woman CEO sends a message to your brain. When we have role models from diverse groups, it has a huge impact for people both inside and outside those groups. Representation matters.
When I’m in the clinic, I usually spend 20 minutes seeing a patient — but see between eight and 10 patients in an afternoon. I’m also checking messages, writing notes, answering phone calls, helping residents and signing orders.
Doctors multi-task under tight time constraints, making high-stakes decisions in a stressful environment. Take that work environment and mix it with the way we’re taught as medical students to recognize patterns. Disaster! Health care providers are especially susceptible to working fast and using shortcuts to jump to a diagnosis, but experienced professionals in many industries can fall victim to this behavior.
When dealing with others — or making decisions that can impact them — try to find a way to focus and be mindful. (This is much easier said than done.) I know that I have biases. So when I’m about to go into a room, I take 30 seconds to “clear the slate.” Take a deep breath. Actively work to be thoughtful and present in the moment, instead of bringing baggage or distraction from another experience or task.
We all carry unconscious biases with us to work — but by building our own awareness, mitigation and mindfulness strategies, we can reduce the impact they have on ourselves and others.
René Salazar, MD, is an expert in diversity and inclusion practices whose work has been featured by the Association of American Medical Colleges and National Public Radio (NPR). He is the assistant dean for diversity and a professor of medical education at Dell Medical School at The University of Texas. In addition, he treats patients in the greater Austin area.