We’ve talked about how unconscious bias, stigmatizing language, and stereotypes can impact patients. But biases impact clinicians, too. Whether it’s with supervisors, co-workers, or patients and their families, clinicians are also on the receiving end of biases that impact their work and well-being.
Bias Against Clinicians
Clinicians may face bias from patients and patients’ families. One study found that over one in five physicians experienced a patient or family that refused to let them provide care because of the physician’s personal attributes within the last year. In addition, the study found that within the previous year, 29.4% of physicians were subjected to racially or ethnically offensive comments and 28.7% of physicians experienced offensive sexist comments by patients, families, or visitors. Similar evidence is found in other research, such as this study of foreign-born physicians that found that their biggest sources of discrimination were patients and patients’ families.
There are other sources of bias and discrimination towards clinicians. Studies have found that physicians of color experience racism and discrimination from colleagues and their institutions. And a 2022 report showed that two out of three women physicians have experienced or know someone who has experienced gender discrimination from a work colleague.
Bias and discrimination have a negative impact on clinicians’ mental health and careers. A meta-analysis found that discrimination in the workplace is associated with adverse effects on physicians’ careers, work environment, and health. Discrimination can also lead people to leave their profession, which starts as early as while in medical school. This is doubly problematic, because women physicians and racial minority physicians were more likely to report discrimination or mistreatment within the last year. And women and people of color are already underrepresented in the medical field. Discrimination and bias may be another factor that slows the closing of this gap.
A lot of instances of bias or discrimination are not formally reported. A study found that 97% of residents who experienced or witnessed gender-based discrimination didn’t report the experience, with most saying they didn’t think anything would happen if they did report it. In fact, of the 10 residents who did formally report an incident, only one said that something was done about the incident. This means that clinicians are left to deal with the bias an discrimination on their own, and that nothing is changing to prevent this from happening again.
Suggestions for Improvement
There isn’t one clear solution to prevent all bias and discrimination, but there are steps that organizations can take to make the work environment a more physically and psychologically safe and inclusive environment for everyone. One common solution is implicit bias training.
Not all implicit bias training is effective. A meta-analysis showed that training to change implicit biases does not necessarily lead to changes in behavior. So even though a training session may say that it reduces bias, it may not be enough on its own to change behaviors.
However, when paired with strategies for how to change behaviors and track that progress, the training is more effective. Researchers at Harvard did a study where they implemented implicit bias training that not only increases awareness of bias and its impact, but also teaches people to manage their biases, change their behaviors, and track their progress. They found that employees showed less bias and prejudice weeks after the training, and that women, people of color, and people with disabilities felt a greater sense of belonging and respect for their contributions. You can learn more about this training here.
It’s important for organizations to have open conversations about how bias and discrimination impacts their employees. Employees should get the opportunity to speak freely about their experiences and offer suggestions for improvement without any repercussions. Working with employees can help create solutions that actually make a difference. It may be creating processes to effectively deal with acts of discrimination, or providing safe spaces for underrepresented groups to share their stories, offering mental health services, creating hiring practices to develop a more diverse workforce, or any other ideas that the organization and employees collectively agree on.
What has your organization done to reduce bias and discrimination against healthcare workers? What are some strategies you think would be effective? Let us know on social media.