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When it comes to bias, doctors need to do their homework

Monique Rainford, MD
Physician
July 29, 2021
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I used to be a big fan of The Bachelor, particularly when I was single.  What an efficient way to meet potential suitors! (If you can get past every relationship being public.) Chris Harrison seems like a nice guy, and I never noticed any obvious signs of racism over the years.  However, the recent events that ultimately led to him parting with the franchise, in my opinion, point out a few things.

At a minimum, given his interview with Rachel Lindsay earlier this year, he has implicit bias.  Maybe he genuinely thought he was defending another human being without realizing that he was adding more pain and abuse to another person. Regardless, given his career choice and the profile it carries, it is no excuse.   The significance of implicit bias and the negative effect it has in multiple ways on Black people in America has been in the mainstream media for enough years that he should have known better.  I do recognize that he may not have been innately aware of his implicit bias because, by definition, this is not available through introspection, but I am suggesting that given what the past year have shown many Americans about race and racism in America, the significance of implicit bias, his role in the entertainment industry, his hosting the show with the first African American woman four years earlier and the controversial situation that he was being interviewed for, he should have done his homework.

Physicians and health care professionals should be held to the same standard.   It has been shown for years that “health care professionals exhibit the same levels of implicit bias as the wider population.”

We should know that implicit bias exists, and we are likely to have it.  Such awareness will improve the care that we provide for our Black patients. However, based on the lack of progress in eliminating health disparities, we are failing.

While programs to eliminate implicit bias are generally reported to be ineffective, at least one study has shown that interventions targeting persons who care about their own biases may be useful.

If we choose to go into health care, we should care.

I have no doubt, given my extensive experience in health care and being a Black woman in America, that we as health care professionals have made the same mistakes as Chris Harrison with our patients.  Instead of listening to and validating our patients’ concerns, we make excuses for ourselves or the people who have caused the injustice that our patients are experiencing.  Effectively we delegitimize or invalidate their concerns, and we exacerbate their pain due to the experience.  In some ways, our role as clinicians, combined with the reason for them seeking health care, magnifies and even eclipses the pain from the original experience causing an even more damaging effect.  Whether or not we believe their experience is real or perceived is irrelevant.  We are no authority to know the difference, and when a patient is in our care, it is our responsibility to place their needs first.

As health care professionals, we should strive to validate our patients’ feelings and offer comfort whether or not we agree about the etiology. Resist the urge to justify or defend the perceived abusers.    I believe that this could potentially improve our relationship with our patients and improve their care and, as a bonus, make us more empathetic to the other people in our lives.

Monique Rainford is an obstetrician-gynecologist.

Image credit: Shutterstock.com

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