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Prejudice in the Health Care System: Remediation Strategies

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Prejudice, Stigma, Privilege, and Oppression

Abstract

A growing evidence base suggests health care professionals are subject to the same biases as the general public, and these biases can unintentionally influence the quantity and quality of health care. Specifically, it highlights the ways in which physician biases impact decision-making, potentially leading to health care disparities. Many studies have investigated how awareness, through introspection and formal measures of bias, might impact behavior; however, few have offered empirically supported training packages that teach physicians behavioral skills they can use to manage bias. This chapter provides a critical review of the most common recommendations for mitigating bias and suggests that an existing approach, acceptance and commitment training (ACT), can address some of the limitations and inconsistencies prevalent in the literature. We conclude with an outline of the ongoing research at one school of medicine, in hopes of inspiring others to consider similar approaches to the management of bias.

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Notes

  1. 1.

    Although the term association is used widely throughout the literature to refer to learned associations between stimuli, RFT proposes human beings learn to derive relations between stimuli that share no formal properties. That is, human beings can relate stimuli (both arbitrarily and nonarbitrarily) “in the absence of any direct reinforcement for doing so” (Hughes et al., 2012, p. 23). This includes complex relating that captures more than “sameness” (Hayes et al., 2001). For this reason, the terms relation, relating, and relate will be used instead of association.

  2. 2.

    For related work on implicit bias and interprofessional communication, see Baker et al. (2015) and Maraccini, Houmanfar, Kemmelmeier, Piasecki, and Slonim (2018).

  3. 3.

    The interdisciplinary team includes leaders in medical education, members of the Performance Systems and Technology Lab in the Behavior Analysis program (faculty and students), faculty from the School of Journalism, and medical students.

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Author information

Authors and Affiliations

  1. University of Nevada, Reno, Reno, NV, USA

    Jovonnie Esquierdo-Leal

  2. Department of Psychiatry and Behavioral Services, University of Nevada, Reno School of Medicine, Reno, NV, USA

    Nicole Jacobs

  3. University of Nevada, Reno School of Medicine, Reno, NV, USA

    Shanna Strauss

Authors
  1. Jovonnie Esquierdo-Leal
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  2. Nicole Jacobs
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  3. Shanna Strauss
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Corresponding author

Correspondence to Jovonnie Esquierdo-Leal .

Editor information

Editors and Affiliations

  1. Department of Psychology, University of Nevada, Reno, Reno, NV, USA

    Lorraine T. Benuto

  2. Department of Psychology, University of Nevada, Reno, Reno, NV, USA

    Melanie P. Duckworth

  3. Department of Psychology, University of Hawaii, Honolulu, HI, USA

    Akihiko Masuda

  4. Department of Psychology, University of Nevada, Reno, Reno, NV, USA

    William O'Donohue

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Esquierdo-Leal, J., Jacobs, N., Strauss, S. (2020). Prejudice in the Health Care System: Remediation Strategies. In: Benuto, L., Duckworth, M., Masuda, A., O'Donohue, W. (eds) Prejudice, Stigma, Privilege, and Oppression. Springer, Cham. https://doi.org/10.1007/978-3-030-35517-3_18

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