According to Psychology Today,
“Unconscious [or implicit] bias is measurable, widespread, disassociated from conscious bias, and is now cognitively and quantitatively validated. It is reflected in attitudes or stereotypes that affect one’s understanding, decision-making, and behavior, without consciously realizing it in many instances.
We are all biased, whether we are conscious of our stereotypes or not, so we should acknowledge this and strive to understand biases to deal with them appropriately.
The first step in solving any problem is to recognize its existence. Understanding the science related to identifying and conceptualizing bias helps us to recognize and acknowledge bias and its possible effects. The following discussion reviews many of the scientific factors revealing bias.”
In various studies, scientists have found measurable correlation between amygdala [the brain’s emotional center] activity and implicit racial bias. The point again is that research shows a visual brain response, even though an individual may not be conscious of it.
Tragically, Psychology Today’s admonition that “The first step in solving any problem is to recognize its existence [by] understanding the science related to identifying and conceptualizing bias” is all too often ignored or disregarded.
A recent case involving severe bias and discrimination in a Canadian hospital reveals that much work is badly needed to raise awareness of bias and its often insidious manifestations.
According to The Conversation:
“Foreign-trained physicians at Regina General Hospital have alleged that discriminatory practices by the hospital’s “racist, and discriminatory leadership” have led to them being targeted and sidelined.
Ten physicians trained in Africa and Asia filed a complaint with the Saskatchewan Human Rights Commission alleging they have faced bullying, harassment and racial discrimination. They claim that since a new director for the division of internal medicine was hired, white physicians have been given more favoured shifts.
When the physicians brought their concerns to hospital administrators, they said their complaints were dismissed. A Saskatchewan Health Authority (SHA) spokesperson said the health authority was committed to having a representative workforce and would not comment on legal matters. Saskatchewan’s health minister said the SHA has launched a third-party investigation into the circumstances.”
Further reporting by CTV provides additional details of the doctors’ October 5 complaint:
“The complaint… alleges that the 10 physicians in the internal medicine unit, all of whom trained in Africa or East Asia, had no complaints about their work environment until earlier this year when Dr. Bonnie Richardson became lead of the hospital’s department of medicine.
The complaint alleges that Dr. Richardson and her colleague Dr. Linas Kumeliauskas, who became lead of their division of internal medicine, fired the person who made the physician schedule for hospital-based shifts and began scheduling shifts themselves.
The 10 doctors allege the shifts were no longer fairly divided among the 17 members of the department. Instead, the doctors say the most sought-after shifts, including teaching shifts where doctors train medical postgraduates on the job and shifts that offered a premium for additional work, went almost entirely to white physicians. The allegations have not been proven in court.
It was quite brazen,” Dr. Olu Ogundare, a physician from Nigeria who moved to Regina in 2020, told CTV National News. We … people of colour and the people that are not in the favoured group, got zero.
We feel we are racially discriminated against,” Dr. Babatunde Adewunmi, a physician from Nigeria, who practiced in the U.K. before moving his family to Regina, told CTV National News.
It was a wonderful place to settle in—inclusive—and that has been my experience 100 per cent up until (recently),” Dr. Adewunmi said. It’s literally (become) the most toxic place, any one of us has ever walked in…
When they raised their concerns about their treatment with hospital administrators, the … doctors said their requests for fair treatment were dismissed. Some allege they then faced increased harassment and bullying, including frivolous complaints about their work to the College of Physicians and Surgeons of Saskatchewan.
A number of people(‘s shifts) … were cut down significantly in an effort to get them to leave,” he suggested. He adds he co-signed the human rights complaint in support of his colleagues. “I feel like it’s the right thing to do in this situation,” said Dr. Thomas Perron who is white.
This is a really exceptional case, ” Brooke Shekter, a health law specialist in Oakville who is representing the group of physicians, told CTV National News. “You have the majority of the division of internal medicine and the majority of those physicians are people of colour. And they are coming forward to their hospital leadership saying we are being discriminated against on the basis of our race, and they are ignored.
Health care bias has been well-documented. For example, a 2023 study by the Society of General Internal Medicine in the United States, “Implicit Bias among Physicians and its Prediction of Thrombolysis Decisions for Black and White Patients” concludes:
“… our findings suggest that physicians, like others, may harbor unconscious preferences and stereotypes that influence clinical decisions.
We cannot and do not suggest that unconscious bias among health professionals is the largest or most important factor leading to disparities in health care. However, the fact that it is, by its very nature, hidden from conscious awareness suggests that it receive explicit attention.”
To combat and alleviate the manifestations of bias, which can be illegal, and to further educate staff, organizational culture is critical. Organizational leadership and processes can send unequivocal messages to staff that bias and its potentially discriminatory manifestations shall not be tolerated, no excuses. Such an approach is especially salient when also attempting to address health equity and health care disparities. Both efforts go together. Logically, they cannot be separated.
Indeed, according to Dr. Onyenyechukwu Nnorom, an assistant professor at the University of Toronto who studies racism in health-care focuses on how bias impacts what should be health care’s bottom line – the patients.
“[W]hile many hospitals in Canada are actively working on eliminating racial bias, its continued existence is demoralizing for doctors and nurses, and endangers patient care.”
© Bruce L. Adelson 2023. All Rights Reserved The material herein is educational and informational only. No legal advice is intended or conveyed.
Bruce L. Adelson, Esq., is nationally recognized for his compliance expertise. Mr. Adelson is a former U.S Department of Justice Civil Rights Division Senior Trial Attorney. Mr. Adelson is a faculty member at the Georgetown University School of Medicine and University of Pittsburgh School of Law where he teaches organizational culture, implicit bias, cultural and civil rights awareness.
Mr. Adelson’s blogs are a Bromberg exclusive.