Can Health Care Be Cured Of Racial Bias? : Shots - Health News A growing body of research suggests that doctors' racial biases and other prejudices continue to affect the care patients received. Medical educators say self-awareness is an important first step.
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Can Health Care Be Cured Of Racial Bias?

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Can Health Care Be Cured Of Racial Bias?

Can Health Care Be Cured Of Racial Bias?

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ROBERT SIEGEL, HOST:

We're going to take on this health question now - can the medical profession be cured of racial bias? A growing body of research suggests that doctor's internal prejudices may affect the health care we receive. From member station KQED in San Francisco, April Dembosky reports that some medical schools are trying to combat that. They're training their students to confront their own unconscious bias.

APRIL DEMBOSKY, BYLINE: Jane Lazarre was pacing in the hospital waiting room. Her son Khary was 18 at the time, and he'd just come out of knee surgery. But the nurses weren't letting her in to see him.

JANE LAZARRE: They told us he would be out of anesthesia in a few minutes. He never came out. The minutes became an hour. The hour became two hours.

DEMBOSKY: Lazarre and her husband called the surgeon in a panic. He went in to check on their son.

LAZARRE: And came back and said that Khary had come out of the anesthesia violently, thrashing and flailing about.

DEMBOSKY: The doctor told Lazarre that with most young people his age, there wouldn't have been a problem. The doctors and nurses would have gently held him down.

LAZARRE: But with our son since he was so, quote, "large and powerful," they were worried that he might injure the medical staff. So they had to keep sending him back under the anesthesia.

DEMBOSKY: Khary was six feet tall, but he was slim.

LAZARRE: He wasn't the giant that they were describing him as.

DEMBOSKY: Lazarre is white. Her husband is black. She says there's no doubt her mind that what happened with Khary was because of race.

LAZARRE: I understood, certainly not for the first time, that my son - and my sons both were viewed as being dangerous, being potentially frightening to people who were white.

DEMBOSKY: She's sure the surgeon didn't see his reaction as biased.

LAZARRE: Like most white people, I don't think he was conscious of it at all.

DEMBOSKY: Lazarre and her husband insisted on seeing Khary. They saw right away that their son wasn't angry or violent. He was scared. Lazarre leaned over and whispered in Khary's ear.

LAZARRE: It's going to be OK. You can calm down, and he began slowly to come out of the anesthesia more normally.

DEMBOSKY: This happened years ago, but some medical schools today are looking for new ways to prevent these kinds of situations. Places like Johns Hopkins and Baylor College of Medicine are teaching their students about unconscious bias. Take this class for pharmacy residents at UC-San Francisco taught by Dr. Rene Salazar.

RENE SALAZAR: A lot of folks come to San Francisco thinking, oh, you know, it's such an open-minded place. There are no biases here. Actually that's not really true. I mean, you're going to see this - every hospital it's going to be an issue.

DEMBOSKY: What Salazar wants these students to talk about is not other people's biases, but their own. And not just the biases they know they have, but the ones they don't know or don't believe they have.

SALAZAR: Like it or not, all of us hold unconscious beliefs about various social and identity groups.

DEMBOSKY: Before the class, students were asked to take the implicit association test. It's a timed computer test that measures people's unconscious attitudes around race, gender, age and weight. Professor Salazar asks who wants to share their results. The students study their fingernails.

SALAZAR: Well, I can share with you my story, all right?

DEMBOSKY: When he did the test for the first time, it showed that he had a bias against African-Americans.

SALAZAR: I was struck.

DEMBOSKY: He began to explore where this bias came from.

SALAZAR: I grew up in south Texas - 99 percent Mexican-American, mostly Latino - and in my high school, we had one black student.

DEMBOSKY: After Salazar tells his story, a student named Amanda raises her hand. She asked that we not use her last name because she's afraid that what she learned about herself could damage her career. Her parents grew up in Iran and made their way to the U.S. after the revolution. She took the test that measures bias against Muslims and another on light and dark skin tone.

AMANDA: I kind of went in thinking that these are two areas that I would probably not have a bias in. And that's kind of why I choose them.

DEMBOSKY: But the results were not what she expected.

AMANDA: It was, like, actually, you're really - you're biased. And you don't like brown people. And you don't like Muslims which is interesting for me 'cause that's kind of the two things that I am.

SALAZAR: Right, right, absolutely right - and I think that's such an important thing to acknowledge.

DEMBOSKY: Salazar tells the class that the key to understanding bias is not to deny it, but to accept it. And he emphasizes that while unconscious beliefs can't be eliminated, they can be managed.

SALAZAR: So how do we address our biases? What do we do?

DEMBOSKY: One student says slow down.

SALAZAR: Yeah. A trick that I use is I pause before I walk in just to try to clear your mind and try to go in with that clean slate.

DEMBOSKY: It's too early to say if these new trainings actually have any effect on what goes on in the exam room. Salazar admits they don't know.

SALAZAR: The key is what's the impact on patient care? And that's a little bit harder to assess.

DEMBOSKY: But UC-San Francisco is betting that this is the future of diversity training. The school believes it can help shift medicine by teaching the next generation of doctors, nurses and pharmacists how to keep their own biases in check. For NPR News, I'm April Dembosky in San Francisco.

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