As NAIDOC Week kicks off in Australia, I feel motivated to write about our role as healthcare professionals when it comes to providing equal and unbiased care to our patients, regardless of race, gender, age, social status or any other area that potentially creates division.
It’s easy enough to say “treat everyone equally”, but when it comes to the real world, there are a few factors at play which can set us adrift. Here are just some examples:
Work environment and culture
Patient demographics
Our own subconscious programming (AKA: bias)
As an individual, it’s pretty hard to control these first two factors. Which is why I want to dedicate this article to looking at the third factor: bias. This is something each of us can (and should) take a look at from time to time, not just for work but for our own personal development.
So firstly, what do I mean by “bias”? Here’s a technical definition:
“inclination or prejudice for or against one person or group, especially in a way considered to be unfair.”
But let’s take a step back even further, and explore how bias can even creep into our subconscious life. And to do that, we usually need to go far back to our early childhood (yes, strap yourself in, we're going for a ride!).
There’s a great quote by Aristotle that reads:
“give me a child until he is 7 and I will show you the man [or woman]”.
What he is getting at here is the first seven years of anyone’s life greatly impacts and predicts their character and (potentially) the rest of their life.
This is because young children are so impressionable by the world around them. They are constantly taking in information about how to act, what is safe, what is dangerous, etc. so that they can fit in and survive in the world. This consistent analysis of what is safe/dangerous, good/bad, right/wrong, etc. inevitably forms what we call the ego.
One’s ego is not necessarily a bad thing, but it can get us into trouble if it is left to grow unchecked. This is because the ego wants to identify itself as separate to the rest of the world. This is how it keeps us “safe”, because it identifies potential external threats as being separate from itself. What this can lead to is a “me vs. them” mentality, or “I’m right and they’re wrong” attitude.
If a child grew up in an environment where it was commonplace for a particular group of people to be treated differently, then their subconscious programming (their ego) will be wired to behave in the same manner - to look for this “threat” that does not fit in with their world view. I want to emphasise that this occurs on a subconscious level, meaning we are usually not aware that our ego is making us think and behave in this way (regardless of whether it is deemed “right” or “wrong”).
Now let’s take this concept back to bias in healthcare. Let’s say a non-indigenous child has grown up in an environment where it was a common belief that “all aboriginal people are lazy and can’t take care of their health” (I am obviously using this as an example, as a statement like this simply cannot be true). Now this child has grown into an adult, and is a qualified radiographer working in a hospital. If this person has allowed their subconscious programming to grow unchecked, then the next time they see an aboriginal patient who is of ill-health (regardless of whether or not it was their own doing), this person’s ego will most likely activate and send a message saying “you see, ALL aboriginal people ARE lazy and can’t take care of their health”. It may even manifest one step further and say “why should I look after this person if they aren’t going to even look after themselves!?” - typical me vs. them mentality.
Let’s not look past the fact that it may only take seeing one person to fit this stereotypical profile for their ego to confirm it’s bias. Conveniently, it will probably overlook the other nine people of the same demographic that didn’t fit this profiling. Likewise, it will probably overlook other patients that are in fact lazy and don’t look after their health, but don’t fit this particular racial profile. This is called “confirmation bias”.
We can also look at this concept on the flip side. Let’s say an indigenous person has witnessed first hand their whole life how they and their community have been treated by other non-indigenous people. It could be by the police, the government, or by healthcare workers. Imagine a young indigenous child attending the hospital with their sick mother, only to see their mother not being listened to and not receiving the appropriate care that everyone else seemed to be getting. That would be enough for this child’s ego to form the view that “all healthcare workers do not care about my people”. This concept would only grow as they become older, and the next time they attend a healthcare setting, they would instantly be ready to find a reason to confirm this bias. This may transpire as them acting “rude", "agitated" or “ungrateful”, and if this patient was dealing with the non-indigenous healthcare worker described above, there would be a HUGE clash of biases, creating conflict and tension between the two individuals. In this scenario, nobody wins.
Do you notice how I use the word “it” when describing the ego, not “you” or “I”? I do this intentionally, because although your ego wants you to believe that you and it are the same thing in order to keep you “safe”, you are in fact NOT your ego. This is an important life lesson to learn, because in order to break free of these subconscious biases created by the ego, one needs to become aware that they are separate from their ego. The ego is a shell that was programmed during the early years of life, and has now grown to keep you safe from the perceived threats of the world. The problem is, a lot of these perceived threats (such as people of different race, gender or age) are not threats at all. And until we intentionally make the choice to go back and unpack where it all began, we will continue to subconsciously play out our biases towards our patients and loved ones in our lives.
Now obviously I’ve covered A LOT of big concepts here (and you probably thought I was just going to give you “5 simple tips to stop being biased towards your patients!”). This sort of work to disengage from the ego and start inquiring into why you act the way you do is a lifetime process, but the best time to start is NOW.
There are many tools and resources out there to help you on this journey of self-discovery. For me, I have found breathwork and meditation to be hugely helpful (so much so that I have now trained to become a breathwork facilitator!). Even talking to a counsellor or therapist could be beneficial for a lot of people who aren’t necessarily having a mental health crisis. Mental health is not about “fixing” mental disorders; it’s about being proactive, just like going to the gym to keep our physical health in good shape. Train your mind, learn to watch and inquire into your subconscious biases, and you will become a healthier, happier person and a much better healthcare professional for your patients.
If you would like to explore breathwork and meditation to start you on your journey, I offer 1:1 online sessions and in-person sessions in Wollongong, NSW. You can find out more and book me at www.tristancharles.com.au
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