“Awareness is the first step to change”

I’ve been meaning to share this thoughtful article with you. Dr. Manoj Jain, an infectious disease physician in Memphis, did some soul-searching about if his own prejudices influence how he sees patients, the assumptions he makes about their lifestyles and health, and the care he gives. He said his own complexion is Asian-Indian, which sets him apart and he wondered if his patients see him differently when he walks in the room. The raw honesty and perceptiveness makes his article worth reading in its entirety:

How I Learned to Treat My Bias

...Then I wondered: When I walk into a room, how do I see my patients? For the next few days I observed myself whenever I entered a hospital room to see a new patient. To my surprise, I realized that in the initial glance I viewed patients as an “elderly black man" or a “Hispanic worker" — and all the baggage that comes with their race, gender and ethnicity. My prejudices had kicked in.

Unfortunately, the entire health system sees patients by race, gender and ethnicity, and it has a profound effect on how care is delivered. The Institute of Medicine in its 2002 report “Unequal Treatment" cited some provocative statistics. Black patients, for example, tend to receive lower-quality care for cancer, heart disease, HIV, diabetes and other illnesses. Black men are 40 percent more likely to die of cancer than white men. These differences often persist even after accounting for age, severity of illness and delays in seeking treatment among different groups. How can this happen in America in 2007? ....

[E]ven though I believe that I do not judge people based on stereotypes, the data show it is very likely that I do.... my stereotypes probably guide my expectations and handling of the patient, resulting in a self-fulfilling prophecy....

It is painful to write these things. As health-care workers we try to be unbiased in our delivery of care. Once I became aware of how I thought when I encountered patients, I was able to start changing.... As a society we can overcome prejudices in health care by facing our tendency to stereotype....

He closed with a powerful suggestion for all of us. “The next time you see a worker at a fast-food restaurant, ask yourself: What stereotypes did your mind automatically activate?

Awareness is the first step to change.”