Skip to main content

Overcoming Bias from Patients and Their Families: Protecting Our Trainees and Ourselves

  • Chapter
  • First Online:
Diversity, Equity and Inclusion

Part of the book series: Success in Academic Surgery ((SIAS))

  • 1028 Accesses

Abstract

In recent decades, surgeon demographics have become more representative of the broader US population; thus, surgical patients will increasingly find themselves receiving care from surgeons from diverse backgrounds. As this transformation occurs, patients and their families will sometimes rely on outdated heuristics and bring their own implicit and explicit biases when interacting with healthcare professionals. To prevent this, strategies to mitigate discrimination can be implemented by three key actors: surgeons themselves, surgical teams in the course of patient care, and hospitals (Table 8.1).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 64.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 84.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Chambers CC, Ihnow SB, Monroe EJ, Suleiman LI. Women in orthopaedic surgery: population trends in trainees and practicing surgeons. J Bone Joint Surg Am. 2018;100(17):e116.

    Article  Google Scholar 

  2. Sexton KW, Hocking KM, Wise E, et al. Women in academic surgery: the pipeline is busted. J Surg Educ. 2012;69(1):84–90.

    Article  Google Scholar 

  3. (AAMC) AoAMC. The state of women in academic medicine: the pipeline and pathways to leadership; 2014.

    Google Scholar 

  4. Butler PD, Longaker MT, Britt LD. Major deficit in the number of underrepresented minority academic surgeons persists. Ann Surg. 2008;248(5):704–11.

    Article  Google Scholar 

  5. Burgess D, van Ryn M, Dovidio J, Saha S. Reducing racial bias among health care providers: lessons from social-cognitive psychology. J Gen Intern Med. 2007;22(6):882–7.

    Article  Google Scholar 

  6. Clark JA. Explicit bias. Northwestern Univ Law Rev. 2018;113(3):505–86.

    Google Scholar 

  7. Santry HP, Wren SM. The role of unconscious bias in surgical safety and outcomes. Surg Clin North Am. 2012;92:137–51.

    Article  Google Scholar 

  8. Hu YY, Ellis RJ, Hewitt DB, et al. Discrimination, abuse, harassment, and burnout in surgical residency training. N Engl J Med. 2019;381(18):1741–52.

    Article  Google Scholar 

  9. Jenner S, Djermester P, Prügl J, Kurmeyer C, Oertelt-Prigione S. Prevalence of sexual harassment in academic medicine. JAMA Intern Med. 2019;179(1):108–11.

    Article  Google Scholar 

  10. Pololi LH, Brennan RT, Civian JT, Shea S, Brennan-Wydra E, Evans AT. Us, Too. Sexual harassment within academic medicine in the United States. Am J Med. 2020;133(2):245–8.

    Article  Google Scholar 

  11. Yahanda AT, Lafaro KJ, Spolverato G, Pawlik TM. A systematic review of the factors that patients use to choose their surgeon. World J Surg. 2016;40(1):45–55.

    Article  Google Scholar 

  12. Bucknor A, Christensen J, Kamali P, et al. Crowdsourcing public perceptions of plastic surgeons: is there a gender bias? Plast Reconstr Surg Glob Open. 2018;6(4):e1728.

    Article  Google Scholar 

  13. Ashton-James CE, Tybur JM, Grießer V, Costa D. Stereotypes about surgeon warmth and competence: the role of surgeon gender. PLoS One. 2019;14(2):e0211890.

    Article  CAS  Google Scholar 

  14. Dusch MN, O’Sullivan PS, Ascher NL. Patient perceptions of female surgeons: how surgeon demeanor and type of surgery affect patient preference. J Surg Res. 2014;187(1):59–64.

    Article  Google Scholar 

  15. Abghari MS, Takemoto R, Sadiq A, Karia R, Phillips D, Egol KA. Patient perceptions and preferences when choosing an orthopaedic surgeon. Iowa Orthop J. 2014;34:204–8.

    PubMed  PubMed Central  Google Scholar 

  16. Cil TD, Easson AM. The role of gender in patient preference for breast surgical care—a comment on equality. Isr J Health Policy Res. 2018;7(1):37.

    Article  Google Scholar 

  17. Amir H, Beri A, Yechiely R, Amir Levy Y, Shimonov M, Groutz A. Do urology male patients prefer same-gender urologist? Am J Mens Health. 2018;12(5):1379–83.

    Article  Google Scholar 

  18. Sarsons H. Interpreting signals in the labor market: evidence from medical referrals; 2017.

    Google Scholar 

  19. Bankhead-Kendall B. Surgical patients display an unconscious bias against female surgeons. Paper presented at American College of Surgeons Clinical Congress 2019; San Francisco, CA.

    Google Scholar 

  20. Reddy S. How doctors deal with racist patients. Wall Street Journal; 2018.

    Google Scholar 

  21. Novick DR. Racist patients often leave doctors at a loss. Washington Post; 2017.

    Google Scholar 

  22. Swindler S. Portland doctor Esther Choo responds to racism in the emergency room. The Oregonian/OregonLive; 2019.

    Google Scholar 

  23. Yasmin S. When patients discriminate against doctors: a Muslim physician weighs in. Medscape Psychiatry; 2017.

    Google Scholar 

  24. Kim J. When the patient is a racist. The Health Care Blog; 2017.

    Google Scholar 

  25. Olayiwola JN. Racism in medicine: shifting the power. Ann Fam Med. 2016;14(3):267–9.

    Article  Google Scholar 

  26. Williams JC, Rohrbaugh RM. Confronting racial violence: resident, unit, and institutional responses. Acad Med. 2019;94(8):1084–8.

    Article  Google Scholar 

  27. Paul-Emile K, Smith AK, Lo B, Fernandez A. Dealing with racist patients. N Engl J Med. 2016;374(8):708–11.

    Article  Google Scholar 

  28. CMS.gov. Emergency Medical Treatment and Labor Act (EMTALA); 1986.

  29. Barnes KL, McGuire L, Dunivan G, Sussman AL, McKee R. Gender bias experiences of female surgical trainees. J Surg Educ. 2019;76(6):e1–e14.

    Article  Google Scholar 

  30. Sue DW, Capodilupo CM, Torino GC, et al. Racial microaggressions in everyday life: implications for clinical practice. Am Psychol. 2007;62(4):271–86.

    Article  Google Scholar 

  31. Tschaepe M. Addressing microaggressions and epistemic injustice: flourishing from the work of Audre Lorde. In: Essays in the philosophy of humanis, vol. 24. Sheffield: Equinox Publishing Ltd; 2016. p. 87–101.

    Google Scholar 

  32. Torres MB, Salles A, Cochran A. Recognizing and reacting to microaggressions in medicine and surgery. JAMA Surg. 2019;154(9):868–72.

    Article  Google Scholar 

  33. Fnais N, Soobiah C, Chen MH, et al. Harassment and discrimination in medical training: a systematic review and meta-analysis. Acad Med. 2014;89(5):817–27.

    Article  Google Scholar 

  34. Commission EEO. Title VII of the Civil Rights Act of 1964. In: 1964.

    Google Scholar 

  35. Choo E. [@choo_ek], ed 2019.

    Google Scholar 

  36. Flores G, Mendoza FS, DeBaun MR, et al. Keys to academic success for under-represented minority young investigators: recommendations from the Research in Academic Pediatrics Initiative on Diversity (RAPID) National Advisory Committee. Int J Equity Health. 2019;18(1):93.

    Article  Google Scholar 

  37. Cheung F, Ganote C, Souza T. Microaggressions and microresistance: supporting and empowering students. In: Louisville KY, editors. Faculty focus special report: diversity and inclusion in the college classroom; 2016.

    Google Scholar 

  38. Kogan SM, Yu T, Allen KA, Brody GH. Racial microstressors, racial self-concept, and depressive symptoms among male African Americans during the transition to adulthood. J Youth Adolesc. 2015;44(4):898–909.

    Article  Google Scholar 

  39. Kessler RC, Mickelson KD, Williams DR. The prevalence, distribution, and mental health correlates of perceived discrimination in the United States. J Health Soc Behav. 1999;40(3):208–30.

    Article  CAS  Google Scholar 

  40. Wong CA, Eccles JS, Sameroff A. The influence of ethnic discrimination and ethnic identification on African American adolescents’ school and socioemotional adjustment. J Pers. 2003;71(6):1197–232.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Heena Santry .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2021.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Oslock, W., Barksdale, E.M., Santry, H. (2021). Overcoming Bias from Patients and Their Families: Protecting Our Trainees and Ourselves. In: Telem, D.A., Martin, C.A. (eds) Diversity, Equity and Inclusion. Success in Academic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-55655-6_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-55655-6_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-55654-9

  • Online ISBN: 978-3-030-55655-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics