Print & Go GuidanceBy Sharon Boyd, MA, RDH
Unconscious biases are assumptions, judgments, and opinions we have on people and things without necessarily even realizing them. Those beliefs come instantly and instinctively, whether from the environment we've grown up in, our culture, or even our age. Unfortunately, unconscious bias can cause us to make decisions about our dental patients or care situations that may be inaccurate or not in their best interest.
Since unconscious bias is often instinctual, it takes training, awareness, and practice to unlearn and re-teach ourselves these behaviors, especially if we're serving a diverse patient population or have coworkers with different backgrounds from our own.
Unconscious Bias in Hiring Dental Staff
Hiring processes are one of the most noticeable areas where unconscious bias can affect the dental workplace. There are several different types of unconscious bias that a person can hold. One example is affinity bias. This type of bias is where we naturally tend to gravitate to people who are like us or share a similar background; it can cause us to prefer those people over others, unnecessarily deflecting attention or providing special attention compared to others. For example, we may prefer one applicant interviewing for a hygiene or assisting job if they have similar interests or went to school in our hometown.
Name bias is another classic example. How often do you look at a person's resume or patient records and assume based on the name they provided? Especially if it is a name you cannot pronounce. To counteract this, dentists or office managers can go as far as to black out names or ages on resumes or job applications to prevent unconscious bias during hiring. This helps eliminate the risk of bias, regardless of who reviews the job application.
Stereotyping Dental Patients
Dental practitioners may also inadvertently exhibit an unconscious bias toward their patients, like the affinity and name biases mentioned above. One classic example is ageism, which can include unconsciously discriminating against someone because of how old or young a patient is. Additionally, researchers show that women are more prone to experiencing ageism than men.
Making assumptions that someone is a certain way because of their age could directly impact care planning and treatment plan presentation strategies. For example, we may assume they have a fixed income or share different values regarding treatment options, causing us to avoid presenting all viable choices during the care planning review process. We may only offer one or two treatment scenarios when better but more expensive options are available. For example, one study found that dentists' decision-making and treatment recommendations were directly affected by the patient's race; in this case, it involved recommending extractions over root canal therapy for patients of African American descent.
Patients are also susceptible to weight bias, negatively judging a person who is larger or heavier than what is considered healthy. For example, suppose a patient has difficulty with their mobility or laying back in a dental chair because of weight. In that case, dental practitioners may unconsciously seem less welcoming or open to scheduling them for the required procedures.
Questions to Ask Yourself
How can you tell whether or not you are prone to certain types of unconscious bias? While it's challenging to practice self-reflection regarding our own bias, there are steps we can take to help us identify areas where we can improve. First, consider asking yourself the following and be honest about your answer(s):
- Does this person's religion cause me to think less favorably of them?
- Do I feel negatively about or uncomfortable around a person because of their culture or ethnicity?
- Do I prefer caring for patients who are more like me?
- Do I tend to interact more with my coworkers who I share things in common with?
- Do I recommend different treatment plans based on someone's age, gender, or appearance?
- If this person weighed less, would I treat them differently?
- Do I tend to favor patients or staff who are more attractive?
- Do I tend to elevate certain people based on their accomplishments or social status?
Self-awareness is critical to addressing unconscious bias. As you might guess, it could be embarrassing to identify or even disclose biases we held or once held. Unfortunately, many of those biases are things that we unknowingly learned as we grew up.
Everyone is Biased
When we realize that we all have internal biases of some sort, we're better able to provide fair and ethical care to the patients we serve. In addition, by slowly recognizing our personal biases, we can better adapt our communication strategies and care methods to serve people (or work with peers) of different backgrounds, generations, religions, and medical needs.
The more familiar we become with practicing equal care regardless of our unconscious bias, the better practitioners and peers we become for our communities. The differences may be subtle—or not even noticeable to anyone other than ourselves—but they can tremendously impact the quality of life of those around us.
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Author: Sharon Boyd, MA, RDH, has over 20 years of experience in the dental industry and is the founder of DentaSpeak, LLC. In addition to being a registered hygienist, she serves as a full-time patient education professional with a special interest in strategic dental communications. She often works as a liaison between practitioners and patients, bridging the gap between care needs and patient concerns. Sharon is an Ironman band mom, and enjoys volunteering at her family's church.