How Providers Can Promote Health Equity

Three Steps Healthcare Providers Can Take to Drive Systemic Change

I recently had brunch with two remarkable colleagues in the healthcare field, both deeply committed to addressing disparities in maternal health and cancer that impact Black women. Our conversation revolved around the themes in Dr. Uché Blackstocks' book Legacy. However, we also discussed something equally crucial yet often overlooked—actionable steps toward creating systemic change. It's not enough to merely educate people about implicit biases; we must equip them with tools to mitigate biases' impact on medical decision-making.

Whether we realize it or not, implicit biases can impact healthcare providers' treatment decisions and recommendations. When I was first told that I had the gene that can lead to cardiomyopathy, my healthcare team was initially not concerned because they assumed I had no family or medical symptoms of a heart condition. However, that couldn't have been further from the truth. After asking me the appropriate screening questions, they decided I needed an EKG and echocardiogram. Even though everything returned normal, it illustrates how their implicit bias could have hindered me from receiving preventative care. 

With implicit bias, providers don't want to provide equitable care. Instead, they cannot see how their biases are impacting their decision-making. This makes it even more critical for healthcare providers to embrace the journey toward a more inclusive and equitable healthcare system. 

Healthcare Providers Play a Pivotal Role in Promoting Health Equity

One of the things I've learned along this journey towards health equity is that this work is not only multifaceted but also requires collective effort. By this, I mean we can't do this work alone if we genuinely want to have a lasting impact on the healthcare system. Instead, every healthcare provider has a role in shaping industry policies, practices, and attitudes. By doing so, providers can better provide all patients with the highest standard of care. Furthermore, providers can enhance patient outcomes, strengthen provider-patient relationships, and foster community trust.

This isn't to say that the individual work you do won't have an impact locally, nationally, or even internationally. However, systems change requires a collective effort to address the implicit bias within the system. By addressing the systemic ways implicit biases impact health equity, providers can contribute to a more just healthcare system where everyone receives equitable care, regardless of their background. Thus, providers must understand their role in driving systemic change and equip themselves with practical strategies to address implicit biases in their practice.

Three Steps Healthcare Providers Can Take to Drive Systemic Change

Step 1. Unpack Their Implicit Biases

Implicit biases are unconscious and can manifest in healthcare as racial biases, gender biases, or biases related to socioeconomic status. For example, a healthcare provider may unknowingly hold stereotypes about specific demographic groups, leading to differential treatment or a lack of attention to symptoms.

Consider a scenario where a Black woman presents with symptoms of cardiovascular disease. Due to implicit biases, a healthcare provider might attribute her symptoms to non-cardiac causes or downplay the severity of her condition, resulting in delayed diagnosis and treatment. Considering that chronic conditions disproportionately impact Black women, healthcare providers must bring awareness to their implicit biases. 

Step 2. Recognize the Impact on Patient Care

However, knowing our implicit biases is not enough if we don't recognize the implications for patient care. As we know, implicit biases can contribute to disparities in diagnosis, treatment, and health outcomes. Studies have consistently shown that marginalized groups, such as Black women, experience poorer health outcomes due, in part, to the influence of implicit biases on clinical decision-making. This means biases can lead to misdiagnosis, inappropriate treatment recommendations, and disparities in healthcare services.

Research indicates that Black women are less likely to receive timely and appropriate pain management compared to White patients, leading to undertreatment and unnecessary suffering. This disparity is often driven by stereotypes about Black individuals' pain tolerance, resulting in inadequate pain management interventions. Therefore, providers must be aware of how they perpetuate harm by not recognizing the impact of their implicit bias on their medical decision-making. 

Step 3. Adopt Practical Strategies for Mitigation

While addressing implicit biases requires intentional effort, healthcare providers can adopt practical strategies to mitigate their impact and promote health equity. Cultural competency training, for instance, helps providers recognize and navigate cultural differences in healthcare delivery. Self-reflection exercises encourage providers to examine their biases and assumptions, fostering awareness and empathy towards patients from diverse backgrounds. Additionally, implementing bias interrupters—strategies designed to disrupt biased patterns of thinking and behavior—can help mitigate the influence of biases on clinical decision-making.

For instance, a healthcare organization may implement a mandatory cultural competency training program for all staff members. Through interactive workshops and case studies, providers learn to recognize and challenge their implicit biases, cultivate cultural humility, and deliver more patient-centered care. As a result, providers become better equipped to serve diverse patient populations and reduce disparities in healthcare delivery.

By proactively addressing implicit biases and implementing mitigation strategies, healthcare providers can drive systemic change toward health equity. I hope you've seen the critical role of healthcare providers in driving systemic change toward health equity. 

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