Unconscious Bias
Topic overview
This episode is an interactive discussion about Unconscious Bias between Dr. Todd Ponsky, Dr. Julie Freischlag, Dr. Mary Brandt, Dr. Quinn Capers IV, Dr. Alejandra (Alex) Casar Berazaluce, Dr. Rachel (Rae) Hanke, and Dr. Alexander Gibbons.
Dr. Julie Freischlag is CEO of Wake Forest Baptist Medical Center and Dean of Wake Forest School of Medicine. Dr. Mary Brandt is a Professor of Surgery, Pediatrics, and Medical Ethics at Baylor College of Medicine and a Pediatric Surgeon and Director of the Adolescent Bariatric Surgery Program at Texas Children’s Hospital. Dr. Quinn Capers IV is the Associate Dean for Admissions, Associate Professor of Medicine (Cardiovascular Medicine), and Program Director of the Interventional Cardiology Fellowship at The Ohio State University College of Medicine.
Disclaimer: Due to scheduling conflicts, Dr. Capers' answers were recorded individually and edited to fit the group session.
Music track is adapted from "I dunno" by grapes, featuring J Lang, Morusque.
Artist URL: ccmixter.org/files/grapes/16626
This episode is an interactive discussion about Unconscious Bias between Dr. Todd Ponsky, Dr. Julie Freischlag, Dr. Mary Brandt, Dr. Quinn Capers IV, Dr. Alejandra (Alex) Casar Berazaluce, Dr. Rachel (Rae) Hanke, and Dr. Alexander Gibbons.
- Julie Freischlag, MD
- CEO of Wake Forest Baptist Medical Center; Dean of Wake Forest School of Medicine.
- Mary Brandt, MD
- Professor of Surgery, Pediatrics, and Medical Ethics at Baylor College of Medicine; Pediatric Surgeon and Director of the Adolescent Bariatric Surgery Program at Texas Children’s Hospital.
- Quinn Capers IV, MD
- Associate Dean for Admissions, Associate Professor of Medicine (Cardiovascular Medicine), and Program Director of the Interventional Cardiology Fellowship at The Ohio State University College of Medicine.
2. What is unconscious bias? How has it affected your career?
- Unconscious bias (implicit bias): attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious bias.
- No one recognizes having it.
- Everyone has it.
- http://bit.ly/2DWjKyQ
- Manel: a panel composed exclusively of males.
- Pediatric surgery example: minority children were consistently given less pain medication than white children.
- Concepts: Microagressions, microinsults, microassault, mansplaining, he-peats.
- Implicit Association Test
- Unconscious bias impacts our decision making.
- Oncology example: a minority patient was being treated for cancer and suffered a relapse; nonresponse to medication was labeled as noncompliance, and ineffective treatment was continued; once a different provider evaluated the patient, genetic testing proved that the tumor was no longer susceptible. In this case, adequate treatment was delayed, and the patient’s outcome was affected by this implicit association.
3. How does unconscious bias relate to social identity?
- Social identity is the portion of an individual self-concept derived from perceived membership in a relevant social group.
- Dominant groups: White, male, protestant, cisgender.
- In-hospital assumption that males are doctors and females are nurses.
- Job search assumption that surgeons cannot be leaders or administrators.
- "You are too nice to be a surgeon.”
4. How do you approach a colleague putting together a manel?
- Choose a mosaic.
- A diverse, inclusive team makes more money and more progress and attracts more people to your panel.
- Gender, ethnic, and age diversity will bring different points of view.
5. How can we identify talent outside of our immediate group?
- Reach out to other people by making phone or email connections.
- Mutual acquaintances or even trainees can point out leaders in the field.
- Be intentional in your search and you will often find balance and diversity.
- If we source from other panels, we perpetuate the bias.
6. What can we do to counteract implicit bias?
- Take shame out of the equation.
- Implicit bias comes from the environment you were raised in.
- Awareness leads to action.
- Educate yourself.
- Appreciative inquiry: seek to learn more about diverse populations.
- Taking the test and identifying your biases is the first step to combat them.
- Book recommendation: White Fragility by Robin DiAngelo.
- Find a common group identity.
- Despite individual differences, find where your groups intersect.
- Perspective taking: putting yourself in other people’s shoes.
- Empathy actively opposes unconscious bias.
- OSU example: Admissions committee receiving unconscious bias education.
- All faculty took the Implicit Association Test and had a mandatory workshop on implicit bias reduction strategies.
- Admitted the most diverse class in the history of the school of medicine.
- http://bit.ly/2sLCX3Z
7. What are your take home messages about discrimination in medicine?
- Dr. Brandt
- You have implicit biases.
- They are getting in your way even if you don’t recognize them.
- They get in our way in the community to recruit and retain a strong workforce.
- It takes courage.
- Call out examples of bias.
- Dr. Freischlag
- Own your bias.
- Fixing the problem is a team sport.
- Senior leaders are in a position of power to defend and empower minorities.
- Listen and be open minded.
- Surrounding yourself with a diverse community will help you identify and fix your attitudes and actions.
- Forgiveness and kindness are essential for continuous improvement.
- Dr. Capers
- In a wrestling match between your unconscious bias and your conscious mind, your consciousness will always win.
- If we know what our unconscious biases are, they are easier to overcome.
- We should recognize our times of highest risk for bias.
- It takes work, but we can overcome these biases and it is well worth it.
- Get to know people and develop empathy for them.
- Consider the opposite: when you have data pointing you to one conclusion, find evidence supporting the opposite conclusion to analyze other alternatives before making a decision.
8. How do we use and interpret the results of an Implicit Association Test?
- We should not be using them to screen for jobs or positions, because we would be assigning conscious intent.
- These tests show unconscious associations learned from our environment that can be recognized and modified.
- We should use them as a screening tool for education.
9. How do we bring attention to unconscious bias without being labeled as radicals?
- True leaders will listen to you and help you.
- Choose the right people to approach.
- Most leaders now want to listen to you and be approached.
- New generations bring lots of hope because they have been raised in a more diverse environment.
- There will be people that don’t want you on their team, and that is okay.
- It is a reflection of your integrity. There is nothing radical about trying to do the right thing. Try to educate or politely walk away when it’s not well received.
- Everybody wants to be included.
10. Closing remarks
Music track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: http://bit.ly/38oiDGq
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