Confronting Bias

Confronting Bias

Protests

On Saturday, we watched the news reports as peaceful protests in Seattle turned violent with looting, fires, and the highway shut down.  My husband and I spoke to our kids at dinner that night that we were in strong support of the protests but upset by the violence.  As a former local business owner, my bias is often with other local business owners.  The Nordstroms are local to Seattle and have been very active in giving back to the community so it saddened me to see looting and destruction of their downtown store.

Our teenage daughter called us out on our comments.  Who are we as a white family to judge the path of these protests?  What were we doing to respond to the horrifying death of George Floyd? Despite the pandemic, friends of hers were downtown at the protests.  The value of teenagers (especially my well-spoken, political daughter) is they keep you on your toes and force you challenge your own beliefs and assumptions.

Trevor Noah, in an excellent video, explained her point well.  Society forms based on a social contract between people who agree to live by common rules and ideals.  In our society, rules include we won’t steal and we won’t kill.  The contract is based on the understanding that these rules are true for all of us and will be enforced fairly.  We play by the rules because we trust others will do the same and that allows our society to function. When the terms of the contract are broken and the rules are enforced episodically or only for some, there is no longer a reason for others to continue to abide by these rules.  A new contract is then needed for the community to be able to come together again.

Why are bias and protests relevant to veterinarians?

I believe this topic is relevant to all of us.  When protests and demonstrations impact businesses across the country, veterinarians need to pay attention.  Understanding and empathizing with why these protests are happening will allow us to help push for concrete action to make our communities fair and safe for all. This crisis is the time for all of us to be called upon to look at and understand our personal biases.

It is easy to live in a liberal city as a professional and feel like you are not part of the problem. However, as veterinarians, we have to acknowledge that we are part of one of the least racially diverse professions in the country.  When an AVMA task force in 2006 examined reasons, they identified many contributors including a historic lack of commitment to dedicate resources to this issue.  The AVMA has implemented some of the recommendations of the task force.  Veterinary student populations now include a higher percentage of racially or ethnically underrepresented students than in the past, but still much lower than in medicine.  Leadership at the AVMA is still overwhelmingly white, and there is no racial diversity in the leadership of the companies buying up veterinary practices, as seen in the picture in this blog. It is important to ask, what part does bias play in our lack of professional diversity? And does bias impact the care we provide?

Bias

Everyone has bias that impacts what they do.  Bias can be defined as “disproportionate weight in favor of or against one thing, person, or group compared with another usually in a way to be unfair.”  Bias can exist with areas such as gender, politics, culture, region, class, geography, and education.  If you are consciously aware of your likelihood to be unfair, this is explicit bias. Implicit bias is driven by your subconscious and influences decisions in ways in which you are not aware.  We all have implicit bias as the process of generalizing helps us to make sense of the the world.  Our implicit bias develops from where we grew up, from our education, and also from media, news images, and the world around us. However, this means we can make choices based on stereotype without even realizing it.

Research on implicit bias

In one study, a researcher recruited 135 pre-K teachers and asked them to watch short videos of preschoolers engaged in various activities.  They were told to identify any challenging behaviors that might need to be addressed. In each video, there was a black boy and girl and a white boy and girl.  There were no behavioral differences between the children in the videos and no challenging behavior. However, 42% of the teachers identified the black boy as the child needing more watching.

In another study, landlords across the country were contacted about renting an apartment using mock email messages.  Some of the emails were signed with a black sounding name while others were signed with a white sounding name. The emails were otherwise equivalent.  Landlords were more likely to respond to emails from people with white sounding names.

In medicine, implicit bias has been shown to affect patient care. A study was undertaken of 287 medical residents in Boston and Atlanta.  The physicians reported no explicit preference for black or white patients.  They were presented with clinical cases of acute coronary syndrome presenting to the emergency room and asked whether they would use thrombolysis.  The physicians then answered a questionnaire looking at implicit bias.  Physicians with implicit racial bias were less likely to treat black patients than white patients with appropriate thrombolysis.

So, what should we do?

1) Listen.  I am still against looting businesses as part of a protest (and most of the violence during protests in Seattle has been perpetrated by white men).  But my daughter’s challenge resonated.  I spent several hours reading, learning, and questioning whether I personally am doing what I can in these challenging times.  When we all listen to understand, we can then search together to find solutions.  If you are also in learning mode, I found this to be a great list of readings and videos.

2) Learn about implicit bias.  When you understand implicit bias and try to understand your own, you are less likely to make unintended snap judgements.

This is a great very short video series (each video is about 2 minutes) on implicit bias.

This site allows you to take a test to understand your own implicit bias.

3) Learn how to improve diversity and inclusion in veterinary medicine. It is worth thinking about how you review emails and job applications. Do you have any bias around names that could be impacting who you interview or hire?  Are you sure you offer the same care to every pet despite the gender or race of the owner? If you are a veterinary educator or hospital leader, I would encourage you to look at the coursework on diversity and inclusion from Purdue University.

4) Pay it forward.  If you are employed and healthy, now is the time to help others.

5) Be engaged.  Our country, our states, our cities, and our workplaces are best when we all work to confront our own biases and to create communities that are truly fair and equitable.