To what extent do my beliefs, prejudices, or biases influence my thinking in terms of providing service to my profession?
As I learn more about cultural diversity and explore the different concepts of stereotypes, diversity, biases, and prejudices, it is evident that they are present in everyday life. I would love to think that I treat everyone the same all of the time, but we can’t escape the external influences and experiences that shape how we view the world. Biases are a natural part of life.
I started my reflection of of my biases by taking several of the Harvard Implicit Project Tests (IAT). My first test regarding race indicated that I had “a moderate automatic preference between African Americans and European Americans”. Wow, I don’t really want to be that person. I have had very little exposure living near or working with black people. Perhaps my score was reflective of my lack of exposure more than an obvious bias. (that’s the story I’m telling myself anyways) It was difficult to not be biased taking the test. There was a large part of me that wanted to answer based on what I perceived as right. Answering truthfully based on how I felt was in fact difficult.
My second test scored, “Your responses suggested no automatic preference between Straight people and Gay people.” Again, I actually would have presumed that I would have a bias preferring gay people, since I am one……I was relieved to see that I don’t have a prejudice in this area.
My third test confirmed a bias I am aware of. “Your responses suggested a strong automatic preference for Thin people over Fat people.” It is sometimes difficult to remember that obesity is an illness, and these people are not lazy and careless. At times, I find myself frustrated because the background of physics and image acquisition is much harder on obese patients. So many cancers can be attributed, in part, to diet and exercise. This is an area where I know I will have to continue learning and being open when treating patients of different lifestyles and weights.
My beliefs and biases affect how I care for patients and it is critically important that regularly check in on my biases as I make decisions that affect other people. If I am aware of any biases I harbor, I have the power to change my way of thinking. I need to start by learning about the group, or groups, I have a bias against. I need to make an effort to engage with members of that group. I need to spend time with them and genuinely get to know them. I need to experience these people as individuals, not as representatives of a group.
As I researched topics on stereotypes and biases, I was impressed with the huge amount of information available. It seems that there has been a “bias” named for every possible action. After reading many sources, I chose to focus of three personal examples of when these biases have affected me in my profession.
Selective perception
Selective perception is a bias that influences the way expectations may affect our perceptions. Thanks to selective perception, people pay attention only to the information that meets their expectations. We interpret it in a way that is congruent with our existing values and beliefs. When I first became a manager, I surrounded myself with the people who supported me the most. One of those people was a person who did really good work most of the time, but he often was abrasive in his interaction with his peers (never to me). For a very long time I didn’t really believe the feedback I received when his peers would complain. Selective perception bias caused me to not want to believe because that would contradict my prior beliefs. My brain was trying to avoid emotional discomfort.
Survivorship bias
Survivorship bias is a logical error of concentrating on things (or people) that have passed through some selection process and ignoring those less visible and, therefore, seemingly unimportant. In cancer care this happens frequently. Everyone wants to talk about and hear about the people who beat the odds, not the people to succumb to the disease. I don’t have this bias, I actually have developed the “unsurvivorship” bias over time. I cringe when I see marketing celebrating a survivor. It’s not that I can’t celebrate the successes, it’s that I have huge amounts of empathy for those who won’t survive. How marginalized must they feel when they make people around them “uncomfortable”? How isolating it is when they don’t talk about their experience because of that marginalizing. I will never forget the patient early in my cancer career who was told they only had several weeks to live. Her first comment to me was, “maybe I just didn’t have enough faith”
Authority bias
This bias refers to our tendency to follow or believe the views and instructions of an authority figure. Politicians, celebs, CEOs, and experts in different professions fit into this role now.
Authority bias is the human brain’s tendency to trust charismatic speakers regardless of how empty their speeches are. And though our gut tells us something is wrong, we don’t question it anyway. We listen to the advice of successful people, believing their methods will grant us success. We sometimes consider a boss to make better decisions because, well, they are bosses after all.
I am acutely aware that I am a boss. I am also aware that people who trust me will follow my lead. Because of busy workload and stretched resources, often we are all running at a tremendously fast pace. I sometimes make decisions on a fly-by in the hallway. One day, barely listening to the question that was asked, I answered “yes” and kept on going. The staff proceeded to implement the change I agreed to resulting in several patients receiving incorrect education. It was in that moment that I realized the trust that the staff had in my position and the responsibility I had in recognizing that they will follow my lead. Now, I have frequent huddles with staff. I listen to their ideas and I implement their suggested changes. I challenge them to participate in decisions. As a result, we have better programs that represent more opinions.
- Biases are part of us. It’s my responsibility as a good steward of this world to treat everyone with respect. I need to spend more time reflecting on the biases that surface from my subconscious. Perhaps by recognizing them they will no longer just live in my subconscious. I need to be open and aware and constantly evaluate and challenge my personal thoughts and behaviors.
