The Winning Essay: What Is Bias, and How Can it Affect Patient Care?
Bias – particularly cognitive bias – can be perceived as an algorithm of the mind1 .It’s a systematic pattern of deviation from norm or rationality in judgment and implies an unreasoned and unfair distortion in favor of or against a person or thing2. This essay provides an overview of bias, elucidates the different types of bias, and discusses the potential consequences – and opportunities – bias creates the medical field.
One can distinguish two categories of bias: conscious bias, where people hold explicit beliefs about other groups, manifesting in e.g. racism, sexism, Islamophobia – and unconscious bias. As a cognitive skill, based on a simplified information processing strategy called heuristics,unconscious bias is supposed to help us evaluate information according to how we perceive these through the lens of our values and beliefs, and enable swift judgments and decisions. It however can lead to perceptual distortion, inaccurate judgment, illogical interpretation, and irrationality4. Cognitive biases, such as the availability and affective bias also often cause misdiagnoses, as they cause clinicians to focus on the patient’s initial impressions5.
There are numerous variations of cognitive bias – consequently – no individual is immune to the effects of it. In the realm of healthcare, this can lead to medical personnel unwittingly fueling healthcare disparities, which often leads to patient discomfort or even wrong treatment decisions6. Dr. Lucille Perez, an alumna at the NYMC, was an attending physician at Gouverneur Hospital in Manhattan. She had to treat people with lots of dissimilar cultures and backgrounds. Through this, over time she noticed how she unconsciously practiced racism towards African American people. Dr. Perez worked on changing her behavior, as she felt that this way, she can become a better doctor.
A report from the National Academy of Medicine (NAM) demonstrates that “racial and ethnic minorities receive lower-quality health care than white people – even when insurance status, income, age, and severity of conditions are comparable “7. Another study of 400 hospitals in the US indicates how certain patient groups acquire cheaper and more conservative treatments than others do8. A good example for social bias is the fact that gendered norms are also often consolidated by hegemonic masculinity and andronormativity which results in men ending up getting more feeble pain treatments than they require9, which basically manifests in the clichés humans create.
