Discover the hidden biases that drive your practice

Tiffani Johnson, MD, MSC, FAAP, enthralled a packed room at the American Academy of Pediatrics 2019 National Conference & Exhibition Friday afternoon when she led session attendees to admit that they harbor many hidden biases and discriminatory attitudes toward patients and families that can unconsciously determine how they treat patients, parents, and even office staff.

In Johnson’s interactive session “Blind side: Implicit bias we hide, abide, and push aside,” she first guided her audience through the online Implicit Association Test (IAT) to set a private baseline for individual’s attitudes related to topics such as race, sex, ethnicity, nationality, language, socioeconomic factors, and more. Then the participants paired randomly to discuss what they had discovered about their attitudes toward persons different from themselves.

Johnson defined bias as the tendency to believe that some people or ideas are better than others, which leads to treating certain persons differently based on these beliefs. Implicit bias lies below the surface and may not be recognized by the physician as such, but it may influence a physician’s behavior toward particular patients or their families.

She explained that implicit bias is automatic, activated without one’s control or intent, and pervasive because everyone has some sort of hidden bias.

However, bias is malleable, Johnson said, and can be changed by 1) first being aware, 2) becoming concerned about the consequences and being motived to change, and 3) forming strategies to replace a biased response with attitudes that are more consistent with one’s true beliefs and goals.

Johnson put the attendees in the room through several more group exercises designed to open their minds to the problems caused by such biased attitudes and change their own behaviors. Group discussions produced many “aha” moments that the audience said had opened their eyes and would be introduced into their practices at home.

The take-home message: Be mindful of bias in all its forms; avoid labeling; put yourself in the other person’s place to find empathy, tolerance and understanding; focus on the common identities you share with those you perceive as different; and practice individuation to see the many differences among all persons and accept them.

The session lasted well past its allotted time and continued informally as many attendees gathered around Johnson for more one-on-one discussions.