Question

In this task you will write a reflection about one of the key messages of the unit: Biased treatment matters in health care.
Reflective writing should demonstrate critical reading and thinking skills. The use of ‘I’ is expected in this assessment task (‘I think, I do not agree, I agree’, etc). Your essay should follow the following format: Introduction: Briefly identify the main points that you will explore in the essay (approximately 150 words)
1. Define intersectionality and use this framework to describe your cultural location (approximately 200 words)

Answer 1

Introduction :

Biased treatment have been identified as one possible factor in healthcare disparities and the review reveals that they are likely to have a negative impact on patients. The high stress and fast-paced environments in which clinicians operate, health care professionals are particularly vulnerable to an increased reliance on instinctive responses to individuals and situations. As such, even the most well-intended clinician may fall victim to biased decision-making.

As more health care organizations work toward achieving equitable care for all patients, it is not enough to focus on intentional discrimination. We must also acknowledge implicit bias and address it.

implicit bias in health care is also known as unconscious bias, that is “the bias in judgment and/or behavior that results from subtle cognitive processes that often operate at a level below conscious awareness and without intentional control. Implicit bias is not limited to race; implicit bias can exist for characteristics such as gender, age, sexual orientation, gender identity, disability status, and physical appearance such as height or weight.

Implicit bias is “automatically activated and often unintentional. If health care providers understand that stereotyping and racial prejudice are “a normal aspect of human cognition,” they may be more open to learning about this phenomenon and how it impacts medical practice.

To achieve health equity, health care organizations have a responsibility to mitigate the effect of implicit bias in all interactions and at all points of contact with patients. This is important because implicit bias has the potential to impact not only outcomes of care, but also whether patients will return for services or even seek care at the organization in the first place. While a majority of research on implicit bias in health care focuses on racism, other social factors such as primary spoken language, gender, sexual orientation, education, and employment status are also associated with implicit bias and differences in communication and treatment.

Implicit bias may affect how providers and other clinicians interact with patients in terms of communication, treatment protocols or recommended treatment options, or options for pain management. Implicit bias can affect both perception and clinical decision making, and studies show that implicit bias is significantly related to patient-provider interactions and treatment decisions.

For instances, Since black patients are more likely than white patients to die in the ICU receiving life-sustaining treatment rather than in hospice receiving comfort care, Elliott and colleagues tested whether physicians use different verbal and/or nonverbal communication when having end-of-life care conversations with black and white patients and family members. They found that while verbal communication was similar, nonverbal communication scores were significantly lower with black patients than with white patients, with fewer positive, rapport-building behaviors. This difference can affect the outcome of the end-of-life care conversations and contribute to a higher incidence of black patients dying in the ICU while receiving life-sustaining treatments rather than dying at home.

Implicit bias can negatively affect other elements of patient interaction with the health care system. The racial/ethnic minorities, individuals with lower levels of education, and unemployed individuals spend significantly longer time waiting to obtain medical care.

Strategies to Reduce Bias:

Implicit bias in individual interactions can be addressed and countered if we become aware of our bias and take actions to redirect our responses. Devine and colleagues offer six strategies to reduce implicit bias:

· Stereotype replacement — Recognizing that a response is based on stereotype and consciously adjusting the response

· Counter-stereotypic imaging — Imagining the individual as the opposite of the stereotype

· Individuation — Seeing the person as an individual rather than a stereotype (e.g., learning about their personal history and the context that brought them to the doctor’s office or health center)

· Perspective taking — “Putting yourself in the other person’s shoes”

· Increasing opportunities for contact with individuals from different groups — Expanding one’s network of friends and colleagues or attending events where people of other racial and ethnic groups, gender identities, sexual orientation, and other groups may be present

· Partnership building — Reframing the interaction with the patient as one between collaborating equals, rather than between a high-status person and a low-status person

Conclusion :

In the health care area it is 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.