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January 14, 2021
David Burda
Outcomes Policy System Dynamics

Looking for Unconscious Bias in Healthcare? Just Ask Your Customers

When a business is struggling, one of the first things a smart business will do is ask its customers what’s wrong.  It will take the customers’ concerns to heart and then try to and ideally fix any problems. That basic, customer-is-always-right mindset sure is taking a long time to sink in at businesses in healthcare like hospitals, health systems, medical practices, health insurers, pharmacies and others.

A new study in JAMA Network Open reminded me of how much more value the healthcare system could deliver to patients if it just listened to its customers. You can download the study here

Researchers from the universities of Michigan and Illinois wanted to know if patients felt discriminated against by the healthcare system.  So, what on earth did those researchers do to find out? They asked patients! A representative sample of 2,137 of them. 

More than one in five patients—21.4 percent—said they experienced discrimination in the healthcare system. That means the patients felt discriminated against, were hassled or were made to feel inferior while receiving medical care, according to the study.

The researchers gave the respondents a list of 18 possible reasons for the self-reported discrimination.  In ranked order, the patients cited the possible reasons: 

  1. Race or ethnicity
  2. Educational or income level
  3. Weight
  4. Sex
  5. Age
  6. Clinician attitude or behavior
  7. Insurance and health finances
  8. Drug or medication use
  9. Physical disability
  10. Sexual orientation
  11. Shade of skin color
  12. Mental health status
  13. Ancestry or national origin
  14. Speaking English as a second language
  15. Religion
  16. Lifestyle
  17. Height
  18. Other

Interestingly, only 36.9 percent of those who felt discriminated against described themselves as being in poor or fair health. Some 41.3 percent said they were in good health, and 21.8 percent said their health was very good or excellent. So, it seems health status wasn’t a factor in how those patients experienced the healthcare system. 

What is clear is there’s a problem, and it’s one that fuels health disparities and the lack of health equity.

“The results of this study suggest that experiences of discrimination in the health care system appear more common than previously recognized and deserve more attention,” the researchers concluded.

If your hospital, health system, medical practice, health plan or pharmacy really wants to reduce health disparities and improve health equity, a smart place to start is with unconscious or implicit bias. Those researchers from the universities of Michigan and Illinois just gave you a list of what to look for.

All they had to do was ask. Because customers count.

Thanks for reading.

Stay home. Stay safe. Stay alive. The vaccine is coming. 

About the Author

David Burda

David Burda began covering healthcare in 1983 and hasn’t stopped since. Dave writes this monthly column “Burda on Healthcare,” contributes weekly blog posts, manages our weekly newsletter 4sight Friday, and hosts our weekly Roundup podcast. Dave believes that healthcare is a business like any other business, and customers — patients — are king. If you do what’s right for patients, good business results will follow.

Dave’s personnel experiences with the healthcare system both as a patient and family caregiver have shaped his point of view. It’s also been shaped by covering the industry for 40 years as a reporter and editor. He worked at Modern Healthcare for 25 years, the last 11 as editor.

Prior to Modern Healthcare, he did stints at the American Medical Record Association (now AHIMA) and the American Hospital Association. After Modern Healthcare, he wrote a monthly column for Twin Cities Business explaining healthcare trends to a business audience, and he developed and executed content marketing plans for leading healthcare corporations as the editorial director for healthcare strategies at MSP Communications.

When he’s not reading and writing about healthcare, Dave spends his time riding the trails of DuPage County, IL, on his bike, tending his vegetable garden and daydreaming about being a lobster fisherman in Maine. He lives in Wheaton, IL, with his lovely wife of 40 years and his three children, none of whom want to be journalists or lobster fishermen.

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