Jordan M. Miller, 4th Year Pharmacy Student
University of Tennessee College of Pharmacy
Carli C. Smith, PharmD
VA-Tennessee Valley Healthcare System
Jennifer Bean, Pharm.D., BCPS, BCPP
Associate Service Chief of Pharmacy, Clinical & Educational Programs
PGY1 Pharmacy Residency Program Director
PGY2 Psychiatric Pharmacy Residency Program Director
VA-Tennessee Valley Healthcare System
What is Implicit Bias?
Recognizing patterns in the environment around us is part of human nature. Then without realizing it, these patterns can develop into stereotypes. Most people will not admit that they might have biased opinions or stereotypical viewpoints, but unconsciously these thoughts sometimes influence the actions and decisions that are made. This idea of unconscious, uncontrollable, or irrational thought processes that can affect our judgments and daily interactions is known as implicit bias.1 Implicit bias encompasses characteristics of race, gender, sexual orientation, physical appearance, age, financial status, disability, mental illness, and many other areas. Some people associate these characteristics with negative evaluations that can affect the verbal and non-verbal communication, actions, or decisions taken. In the health care industry, clinicians and staff having implicit biases towards certain groups can negatively affect the care that these groups receive.
How Does Implicit Bias Affect the Quality of Patient Care?
Health care workers provide services to a diverse population of patients, so understanding implicit biases is especially important in providing individualized, quality care. Unconscious thought processes and decision-making can affect the provider-patient interaction, therapeutic options, diagnoses, and other areas of health care. A 2017 systematic review revealed that health care professionals exhibit about the same levels of implicit bias as the general population does, and evidence indicates that biases are likely to influence diagnosis and treatment decisions in some circumstances.1 Even professional clinicians with a lot of experience interacting with diverse groups have implicit biases. A 2015 study by Kopera and colleagues showed that mental health professionals had better approach emotions, expressing more compassion, sadness, interest, and acceptance than non-professional, medical students towards mentally ill patients, but both groups held negative implicit bias attitudes towards the mentally ill.2
Most clinicians would agree that everyone should receive the same level of care despite their race, gender, orientation, or physical and mental status. In order to ensure equality of care, it is important to understand cultural competency and establish a framework for preventing implicit bias.
Understanding and Overcoming Implicit Bias
A 2018 survey found that only 17% of CPNP members felt that they were competent in the area of implicit bias. From these results, we can conclude that there is a need for proper tools and guidance to improve awareness and reduce unintentional bias among health care workers. In a 2007 article, Dr. Diana Burgess and colleagues lay out a social and cognitive-based framework aimed to prevent unconscious stereotypes from impacting clinical decisions.3 To reduce bias, the authors propose that is important to treat patients as individuals as opposed to categorically defining them by their group membership. The four pillars of the framework to achieve this, include:
Implicit Bias Keynote Presentation at CPNP 2019
Dr. Quinn Capers, MD, FACC, FSCAI, Associate Dean of Admissions at The Ohio State University School of Medicine, will present “Overcoming Implicit Bias in Health Care,” the Monday opening keynote presentation for CPNP 2019 on April 8, 2019 in Salt Lake City. After this presentation, participants will be able to:
Overall, implicit bias is present among the general population and amongst health care workers. It is important for clinicians to understand and improve upon their implicit biases to provide quality patient-centered care. Join your peers at CPNP 2019 to learn more about this important topic.