Bias in Healthcare: How to Spot It in Yourself

The Bias You Didn't Know You Had
You don’t have to be a bad person to have bias. You just have to be… human.

In medicine, we pride ourselves on objectivity, science, and evidence-based decision-making. But beneath the surface of clinical acumen, guidelines, and protocols lies a deeper force that shapes how we diagnose, treat, and even speak to patients:

Implicit bias.

It’s not always malicious. It’s not always conscious. But it is always present—and its effects on patient care can be profound.

So how do we spot bias? More importantly, how do we spot it in ourselves?

Let’s dissect this with surgical precision.

What Is Bias in Healthcare?
Bias refers to prejudices or stereotypes that affect our understanding, actions, and decisions in an unconscious manner. In healthcare, it can influence:

• How much pain we believe a patient is experiencing
  
  
• How seriously we take symptoms
  
  
• How we explain diagnoses
  
  
• Whether we offer certain treatments
  
  
• How much time we spend with patients
  

And while we’re trained to diagnose diseases, we rarely diagnose our own decision-making patterns.

Common Forms of Implicit Bias in Medicine
Even the most compassionate doctor can carry unconscious leanings. Examples include:

• Racial bias – e.g., assuming pain is exaggerated or minimized based on race
  
  
• Gender bias – e.g., dismissing cardiac symptoms in women as anxiety
  
  
• Weight bias – e.g., attributing all complaints to obesity
  
  
• Socioeconomic bias – e.g., assuming compliance based on insurance status
  
  
• Age bias – e.g., dismissing young patients’ complaints or over-attributing symptoms in older adults to “normal aging”
  
  
• Mental health bias – e.g., labeling patients with psychiatric histories as "difficult"
  
  
• Appearance bias – e.g., making assumptions based on tattoos, accents, clothing, or grooming
  

These don’t make you a bad doctor. They make you human. But unchecked, they compromise care quality.

The Subtle Signs You Might Be Biased
So, how do you detect the invisible?

Here are red flags that bias might be sneaking into your practice:

You interrupt some patients more than others
Watch who gets your full attention—and who doesn’t.

You use different tones or language styles
Are you overly formal with some, more casual with others? Are you subconsciously “code-switching”?

You rush certain consults
Do you spend less time explaining care plans to patients from backgrounds different than yours?

You expect non-compliance before it happens
Are you already frustrated with a patient you haven’t even met yet?

You change management styles without medical reason
Are certain patients getting more or fewer interventions for the same problem?

If you consistently notice a pattern tied to race, gender, appearance, age, or culture, it's not coincidence—it’s bias.

The Science: How Bias Hurts Care

• Black patients are less likely to receive adequate pain medication
  
  
• Women with heart disease are diagnosed later than men
  
  
• Obese patients often have symptoms attributed to weight—missing key diagnoses
  
  
• LGBTQ+ patients are less likely to report issues due to anticipated judgment
  
  
• Non-English speakers often receive fewer preventive services
  

Bias impacts diagnostic accuracy, treatment equity, and patient trust—especially in underserved groups.

Where Bias Lives in the Clinical Day

• In triage decisions: Who seems “urgent” versus “dramatic”?
  
  
• In pain assessments: Who do we believe?
  
  
• In differential diagnosis: Are we using stereotypes to filter symptoms?
  
  
• In treatment planning: Do we alter recommendations based on lifestyle assumptions?
  
  
• In documentation: Are we unconsciously labeling patients with adjectives like “noncompliant,” “frequent flyer,” or “anxious”?
  

Each of these moments is a chance to either reinforce or interrupt bias.

How to Spot and Unpack Your Own Bias
Here are practical tools doctors can use:

1. Use the Implicit Association Test (IAT)
This free tool from Harvard (Project Implicit) offers a quick insight into your unconscious preferences. Not for judgment—just awareness.

2. Audit Your Language
Review your notes: Are some patients described more negatively? Do certain adjectives repeat? That’s data.

3. Track Your “Gut” Responses
Whenever you feel annoyed, rushed, skeptical, or dismissive—pause. Ask: Why? Is this rooted in something clinical—or cultural?

4. Practice Perspective Switching
Try mentally swapping the patient’s background. Would your reaction or management change if this were someone of a different race/gender/body?

5. Diversify Your Echo Chamber
Bias thrives in uniform spaces. Read, watch, and follow voices from cultures and communities different from your own.

6. Invite Feedback from Colleagues
Ask trusted peers: “Do you see patterns in how I interact with patients that I might miss?” It’s humbling—and revealing.

Bias Isn’t Shameful—Avoiding It Is
Spotting bias isn’t about being morally superior. It’s about clinical excellence.

Unaddressed bias isn’t neutral—it harms patients. But recognized bias becomes a tool for growth.

And guess what? Patients notice when you're trying. You don’t have to be perfect—you just have to be aware, reflective, and open.

Final Note: The Best Doctors Never Stop Diagnosing—Even Themselves
Bias won’t show up on your stethoscope or your lab results. It won’t raise alarms on a monitor. But it can be just as dangerous.

As clinicians, we have the training to assess, question, and recalibrate. Let’s use those skills on ourselves, not just our patients.

Because the most powerful clinical tool we have… is self-awareness.