Unconscious Bias in Healthcare The Hidden Threat to Patient Care
Unconscious biases are automatic, unexamined assumptions we make and they happen without our awareness. Research suggests that our brains default to shortcuts, categorising people and situations using observable traits and stereotypes rather than taking the time to consciously evaluate every situation. When we were cavemen, this kind of thinking was life-saving: if something seemed dangerous, we’d run. But in today’s world, where life-or-death decisions are more nuanced, this instinctive “lion-run” mechanism can cause harm; especially in healthcare.
In medical settings, unconscious bias can have serious consequences. A healthcare professional (HCP) may unknowingly allow stereotypes shaped by their background, culture, or personal experiences to influence how they treat patients. These biases might be based on a person’s race, gender, age, weight, or cultural background, and can result in misdiagnoses, poor communication, or inequitable care.
It’s true that certain traits correlate with specific medical risks for instance:
- Obesity is linked to higher risk of heart disease.
- Sickle Cell Anaemia disproportionately affects people of African, Caribbean, Middle Eastern, and Asian heritage.
- White individuals are more likely to develop Atrial Fibrillation.
- Men are more frequently diagnosed with Autism.
- Women are more likely to develop Multiple Sclerosis.
However, when these demographic patterns become assumptions, the results can be harmful. In high-pressure healthcare environments, where appointment times are short and staffing is stretched, decisions are made quickly. That’s when bias creeps in.
Studies have shown the damaging effects of such bias. According to Watman (2018), many HCPs view obese patients as “awkward, unattractive, noncompliant, sloppy, weak-willed, and lazy,” assuming they have brought health problems on themselves. As a result, symptoms unrelated to weight may be overlooked or dismissed, and communication with these patients may suffer.
Similarly, research by Samarrai (2016) found that a significant number of White medical students held false beliefs about biological differences between Black and White people, such as thicker skin, faster blood clotting, or lower pain sensitivity. These misconceptions have led to under-treatment of pain in Black patients and assumptions about drug misuse or medication dependency.
To tackle this issue, we must prioritise self-awareness and communication training for healthcare providers. Helping HCPs recognise their own unconscious biases is the first step toward better care. That means asking the questions they might overlook due to assumption:
- Asking an elderly patient about recreational drug use
- Talking to a Muslim patient about their sexuality
- Discussing career goals with a female patient
These seemingly small actions can make a profound difference ensuring patients feel heard, respected, and valid.
References
- Avoiding Unconscious Bias - MindTools - https://www.mindtools.com/pages/article/avoiding-unconscious-bias.htm
- Weight Bias in Healthcare - Obesity Action (Watman 2018) - https://www.obesityaction.org/community/article-library/weight-bias-and-discrimination-a-challenge-for-healthcare-providers/
- Study on Racial Bias in Pain Management - UVA News (Samarrai, 2016) - https://news.virginia.edu/content/study-links-disparities-pain-management-racial-bias
