Implicit, or unconscious bias, exists in society and in the workplace. When it occurs in healthcare, it can be dangerous in compromising the quality of care we give to patients.  What does it look like?  How can a provider and healthcare organization create an unbiased healthcare environment?  How can management get in touch with their own unconscious biases to combat unintentional bias with colleagues and patients?  Research suggests that unconscious bias regarding race and gender impacts relationships with those we interact with. According to Quality Interactions consulting organization, many non-medical factors influence medical decisions, including a patient’s style of dress, their race, ethnicity, and gender, their insurance status, and the clinical setting (i.e. “bad neighborhood” versus “good neighborhood”). Evidence shows that medical conclusions can be based just as much on who a person is as on the symptoms they present. It is telling, therefore, that one’s unconscious bias is at work in these instances.

We all experience some degree of unconscious bias—yes, even those of us that are well-intentioned.  Unconscious bias includes the subtle associations we make towards groups of people. Stereotypes, which often operate unconsciously, are often the root of our bias. Research suggests that the brain makes decisions up to 10 seconds before we realize it, demonstrating that our decision making is largely unconscious. The phenomenon has been used to partially explain the racial tension in the U. S. and particularly with the police shootings of Black men.  The U. S. Department of Justice (DOJ) recognizes the important role unconscious bias plays in the life of attorneys and law enforcement.  As a result, the DOJ has been rolling out training to more than 23,000 agents in the FBI and other federal law enforcement agencies as well as 5,800 attorneys in 94 U. S. Attorney’s Offices around the country. State and local police and sheriff departments are also conducting unconscious bias training.

 More and more healthcare organizations are incorporating unconscious bias training for providers, healthcare professionals, and managers recognizing the role it plays in healthcare discrimination including patient care, hiring, promotion, retention, and talent management practices. It shapes the organizational climate. One of the challenges in addressing implicit bias is people are often resistant to accepting behavior that is inconsistent with their stereotypes, while accepting behavior that is consistent with stereotypes.

In spite of over 50 years of civil rights law, inequality continues based on sex, race, disability, and other protected classes, as it relates to levels of education, poverty and success. Unconscious bias, influences those inequalities.  Courts have recognized the existence of unconscious discrimination since the earliest Title VII decisions and have specifically stated that Title VII reaches this form of discrimination.

Unconscious bias, or implicit bias, is built into our DNA—it is part of our human nature. It is automatic for humans to categorize individuals and groups to help us make sense of the world.Unconscious bias includes mental shortcuts to categorize people we are unfamiliar with into specific groups.Often those groups are labeled “good” or “bad”. The brain is hard-wired to create these groups and from an evolutionary standpoint, this hard-wiring helped us determine what was safe and what meant danger.  Once assigned to the group, we attribute stereotypes that we associate with that group.Unconscious bias, implicit bias, is different from conscious bias (explicit bias) that most of us associate with overt prejudice such as racism, sexism and other forms of intolerance.