What Are Issues and Solutions to Unconscious Bias in Interpreting Lab Values?
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In this program:
What are some unconscious bias issues and solutions for interpreting lab values? Laboratory medicine scientists Dr. Brandy Gunsolus and Dr. Dana Powell Baker discuss issues that they’ve witnessed in lab tests that are ordered and solutions they recommend to overcome these barriers to proper care.
Transcript
Deandre White:
So, how do unconscious biases and stereotypes among healthcare providers influence the interpretation of lab values, and what strategies can be implemented to mitigate these biases in the lab and educational settings?
Dr. Brandy Gunsolus:
So I have seen more bias and stereotypes in healthcare providers in what tests that they order than the actual interpretation. I have seen everything from in OB/GYN sectors at different facilities where they are only drug testing the moms that they think would be positive and those, unfortunately, are always minority and younger and those of lower socioeconomic status. And I have had to show data time and time again that said that the highest drug offenders are white females between the ages of 30 and 40. [laughter] It's these stereotypes that...
Deandre White:
Shows you the epidemic is very real.
Dr. Brandy Gunsolus:
Right, but they go back to over and over again. And that has in my experience, I have run into more of that, of the ordering practices than the interpretation. I have come across some physicians that have discounted some values based off of race. But more than often it is that they are ordering tests that they should be ordered across the board, or they're not ordering tests because of biases. I have also seen family practitioners where the guy comes in, and he's here for a wellness exam, and he's in his mid-50s. And he really should get an HIV test and an HCV antibody. I mean, HCV antibody is one of those that's part of the now considered standard of care for wellness exams. And I asked the physician, "Do you want these tests?" "No, I know him. He's a good guy. He's a good family man. He doesn't have any of that." Lo and behold, patient actually had HCV. It's one of those things that those stereotypes and those biases, they come in and a lot of times physicians don't even realize that they're doing them because it's part of the way they were brought up.
Deandre White:
Yes, I was going to say it's learned for them as well.
Dr. Brandy Gunsolus:
Yes. And a lot of physicians don't even realize it until somebody points it out to them, and then they have to unlearn what unfortunately their parents taught them when they were younger.
Dr. Dana Powell Baker:
And I'll just quickly add that I think there's also assumptions that come into that. So with the example you just shared of the patient that tested positive for HCV. And so, one would assume how they contracted HCV, but depending on what has happened in their life circumstance wise, they may have received a blood transfusion at one point in their lifetime when we weren't testing for HCV. And so that can be one method of which they contracted it. It doesn't mean that they had a risky lifestyle per se, but sometimes when you do have that positive test, depending on the test, there's that assumption of lifestyle. And that can also change or impact how you're treated as a patient. And so that's something else that we have to address when we talk about biases and stereotyping and so forth. Is the taboo assumption of certain positive tests and just really being comprehensive and there's more than one way to potentially contract a certain disease or condition. So we have to be mindful and just in providing education on that.
Deandre White:
Yeah, and I think there are a lot of assumptions. This is something that particularly affects the LGBT community with assumptions and kind of over testing and you'd...I mean you want to say that over testing isn't a bad thing but it actually can be. And you could be looking for I won't say the wrong thing but you could have a gap in care and not be looking for the right thing, because you're too busy fixated on something else.
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