The Hidden Struggles Healthcare Providers Don't Talk About
How burnout and bias create health disparities in the Black community.
I’m beginning a month-long “digital fast, " meaning I’m being more intentional about my time using digital devices. Since my chosen career requires using a laptop, desktop, and mobile device 95% of the time, I can’t truly “log off” for the rest of the month.
That said, over the last ten days, I’ve discovered that there is not enough time in the day to accomplish all the things I keep piling on my plate. In this short time, I’ve noticed that I am forever “multi-tasking” and starting one project while in the midst of another.
Which is not only not that productive, but I also realize that I am constantly distracted. Rather than being entirely situated in the present, I’m already thinking about what I must do for step five before I’ve completed step one. Can you relate?
For healthcare providers constantly pressured to do more in less time, this is a recipe for burnout and bias. What do I mean by that? Well, let me explain:
Constantly burning the candle at both ends due to time restraints will impact how you show up at work.
For instance, one of my colleagues, let’s call her Kendra, who was beginning her career as a PA. As Kendra was brand new in her field, she took the “above and beyond” approach to her work. She showed up early and stayed late, but after a while, the stress of working so many hours started impacting her performance.
It wasn’t until her managers had to sit her down to discuss a few mistakes she repeatedly made that Kendra realized she was burning herself out. I share Kendra’s example because she took great initiative at her job. However, the time constraints she was enduring—a one-hour commute to and from work and long hours at work—meant she wasn’t getting the rest she needed to show up for her patients fully.
Burnout isn’t the only challenge healthcare providers face, they also need to be aware of their biases.
The thing is that we all have biases, whether we want to admit it or not.
When healthcare providers attempt to ignore their bias, it doesn’t go away, but can impact their clinical decision-making. One such instance is that of a 54-year-old woman, let’s call her Jalessa (not their real name), who was experiencing abdominal bloating and unintentional weight gain. After consulting her healthcare providers she was diagnosed with “monstrous ob*sity.”
However, a physical examination and CT scan after her diagnosis revealed that Jalessa had a 46 kg (101 lbs) mass. Upon a histopathology examination it was further revealed that Jalessa had a tumor composed of three different areas. The doctors who performed the examinations concluded that weight bias could be the only way the other healthcare providers could have missed this.
This is a case study I tend to share often as it’s a clear example of weight bias, which refers to the negative attitudes, beliefs, and stereotypes people hold about others because of their weight. Even though you might be tempted to think that Jalessa’s experience is an isolated incident, it isn’t. Unfortunately, weight bias is prevalent within our healthcare system, and harms Black women - especially those who are higher-weight - in particular.
The truth is that health disparities in the Black community are deeply rooted in inequities that go far beyond individual lifestyle choices. That’s why it’s imperative that healthcare providers not only care for patients but also change the system to make care truly inclusive.
When it comes to weight stigma, the healthcare industry can do a much better job of challenging bias so that providers can deliver more equitable care. Here are three places to start, you might not be thinking of:
1. Invest the Time to Learn About a Weight-Inclusive Approach
As I started this conversation about the time constraints that healthcare providers face, you might be thinking, “I don’t have the time” to read another book or take another training. I will say, you’re right that you don’t necessarily “have” the time, but it’s imperative that you “make” the time. For instance, if you have a private practice, you might block off time in the schedule for you and your employees to take a quarterly training. Or, if you are part of a healthcare system that might mean encouraging whoever is in charge of professional development, to include a weight-inclusivity in this year's curriculum. The point is if providing equitable care matters to you, it’s a necessity that you learn about weight-inclusivity and how to implement a more weight-inclusive approach in your practice.
2. Recognize When You’re Burning the Candle at Both Ends
Providing truly informed clinical care when you’re burnt out is challenging. Whether you’re just getting started and want to make a great impression, or you’ve been in this game for a while and are exhausted, you cannot ignore the impact your burnout will have on those under your care. You don’t want to risk missing something, because you were too burnt out to make an informed clinical decision. If you’re noticing the signs of burnout, such as feeling emotionally drained, insomnia, or decreased productivity at work, it’s time to address it. It’s not just your health at risk, but all those you care for in a burnt out state.
3. Check Your Bias At The Examination Room Door
Bias is embedded within our healthcare system, so providers must be critical about the assumptions they might hold of the patients and clients they care for. That starts with becoming aware when leading with assumptions rather than facts. An assumption might be that a person of lower weight is making healthy food and lifestyle choices. A fact might be that a person of lower weight is engaging in disordered eating and lifestyle habits. A provider wouldn’t necessarily know that by looking at a person, but might discover that by using the available data to ask the right questions. That’s why providing weight-inclusive care isn’t just about misdiagnosis, but ensuring that people aren’t undiagnosed.
As someone who made more than a few mistakes as a health coach, I’m not throwing shade at anyone who doesn’t know what they don’t know. We weren’t taught about weight-inclusivity in school or our certification programs, but that doesn’t mean we don't need to learn it just because we weren’t taught it through formal education.
That’s why I’ll host a live class in a couple of weeks to share proven strategies for providing patient-centered care without relying on weight. Honestly, I wish this class had existed when I first became a health coach. Since it didn’t, I had to learn things the hard way, so you don’t have to.
If you haven’t already, subscribe to the Substack so you’ll be the first to know when the class opens for enrollment.
Talk soon,
Tomesha
P.S. Stay tuned for more details on my upcoming class that will help you break free from the weight-centric model of care. This is your chance to transform your approach to healthcare, and I’m excited to guide you through it!