People may put doctors up on a pedestal, but the truth is that they are human just like anyone else. Every human being who has ever lived has biases, including physicians. Sometimes we are aware of our biases, and sometimes they operate in the background, guiding our behavior without us even realizing it. These so-called “implicit biases” are unconscious assumptions that we make based on the traits of others, such as apparent race or ethnicity, gender, sexual orientation, physical ability, or even weight.
Sometimes, implicit bias prevents a medical provider from taking into account a patient’s input or concerns. In the worst cases, conscious or unconscious prejudices can cause a provider to commit medical malpractice.
How Implicit Bias Can Lead to Medical Malpractice
There are many ways in which bias affects patient care at every step of the medical process, from initial diagnosis, to treatment decisions, to planning for follow-up care. When a doctor’s implicit bias causes injury and damages to their patient, the patient may have a claim for malpractice.
Here are some scenarios in which prejudice can cause medical providers to treat patients differently, potentially with disastrous results.
Diagnostic Mistakes
- Stereotyping: A physician who does not recognize their biases about a group could stereotype a patient who belongs to that group, leading to a misdiagnosis and incorrect treatment. For example, a doctor who evaluated the abdominal pain of a woman with cerebral palsy as appendicitis needlessly removed the woman’s appendix. His stereotype of people with disabilities as non-sexual caused him to overlook the actual cause of her pain: gonorrhea. Another example is that women may be stereotyped as “hysterical” or “dramatic,” and their complaints downplayed or ignored, when a man reporting the same issues might receive diagnostic testing.
- Confirmation Bias: With confirmation bias, people tend to overemphasize information that reinforces their existing beliefs and discount information that counters those beliefs. Confirmation bias may cause a doctor to ignore some of a patient’s reported symptoms that do not fit with the doctor’s assumptions about the patient. For instance, a doctor with implicit bias regarding obesity may attribute a woman’s complaints of pain and fatigue to her weight, even if the symptoms she reports would cause the doctor to order diagnostic testing for a thinner person. As a result, the doctor could fail to diagnose a serious illness such as cancer until the illness was too advanced to treat successfully.
Treatment Errors
- Prescription Errors: False beliefs about racial differences in pain tolerance may cause some doctors to mismanage pain treatment of Black patients, underprescribing medication and allowing patients to suffer unnecessarily.
- Overall Quality of Care: Prejudices regarding certain groups, such as the LGBTQ+ community, may cause care providers to be less empathetic or more dismissive of patients who belong to those groups. In addition to injuring the patient’s dignity, that dismissiveness may cause providers to be less attentive and provide substandard care.
- Communication: Providers with implicit biases may “talk down” to some groups, causing members of those groups to feel misunderstood or disrespected and damaging communication that is essential to diagnosis and treatment. Members of some groups may be given less-detailed information about their condition or their treatment options; that could affect their ability to give informed consent to a procedure.
Discharge and Follow-Up
- Referrals: Doctors may perceive some ethnic or racial groups as being less likely to comply with treatment, or less willing to travel to see a specialist, and be less likely to make a referral for specialized care than they would for a white patient.
- Monitoring of Chronic Conditions: Biases may cause doctors to give some groups less monitoring and follow-up care than others, improving their likelihood of a poor outcome.
What Can Be Done About Implicit Bias in Medicine?
The reality is that even if medical care providers are not aware of their biases, those prejudices are likely affecting the health of their patients. In some cases, stereotyping patients or filtering diagnostic information through biases can lead to misdiagnosis and harm or even death.
Fortunately, the medical community is becoming increasingly aware of the role bias plays in healthcare and taking steps to eliminate both explicit and implicit biases in medicine. Admittedly, this is a major undertaking. Awareness of potential bias is an important first step, but prejudice is difficult to uproot, even for those who genuinely want to do better.
In the meantime, many patients may suffer injury because of their providers’ biases. If you believe that your doctor failed to diagnose or treat you properly, and you were harmed as a result, speak with an experienced medical malpractice attorney. An attorney can help you evaluate whether you have a claim for medical malpractice and your options for pursuing it. To learn more, contact The Fraser Law Firm P.C. to schedule a consultation.
