As you’ve learned throughout this guidebook, cultural sensibility derives from deliberate, proactive behavior. We have to work to educate ourselves (and others) to reflect. When we become aware of our preconceived ideas and biases but strive to separate our personal beliefs from the provider-patient interaction, we can start providing culturally appropriate healthcare. Because healthcare workers know they will interact with different cultures, preparation is important.
BIASES, PREJUDICES, AND STEREOTYPES
As healthcare providers, we determine the essence of the healthcare we deliver. We affect the consumer experience of our care, and our biases, prejudices, and stereotypes (BPS) also impact discrepancies and disparities in healthcare outcomes.
The seminal and in-depth work by Smedley, Stith, and Nelson (2002) in Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare states that “healthcare providers’ diagnostic and treatment decisions, as well as their feelings about patients are influenced by patients’ race or ethnicity” (p. 11). Their work compiled studies from the late 1990s and early 2000s that highlight differences in care based on gender, race, and ethnicity (differences that not only impacted patient outcomes but also led to increased costs in healthcare). Those authors further argued that the sources of healthcare disparities are multilayered, as presented in an integrated model of healthcare disparities. That model highlights three major sources that influence healthcare disparities:
Unique cultural attributes of the patient
Provider clarity and interpretation of healthcare data available
Social, economic, and cultural influences of the healthcare system
Influencing these three components are conscious and unconscious stereotyping and prejudice that can occur with each interaction and may lead to healthcare disparities. Likewise, we have within each of us the power to limit or even eliminate those disparities.
As a reminder, cultural sensibility is a deliberate, proactive behavior by healthcare providers who examine cultural situations through thoughtful reasoning, responsiveness, and discreet (attentive, considerate, and observant) interactions. The healthcare provider is aware of his or her preconceived ideas and biases, but strives to separate personal beliefs from the healthcare provider-patient interaction to provide culturally appropriate healthcare.
Thus far, we have focused on preparing ourselves to be attentive to phenomena that unfold during the patient-provider experience by reconnecting with the essence of healthcare that resides within ourselves (resulting from our original idealism regarding healthcare and our personal motivations/catalysts that led us to this career). We’ve also identified that at the conscious and unconscious level, all of us have personal BPS.
Before we delve deeper into harnessing our BPS, let’s establish a uniform definition for each term (Dictionary.com Unabridged, n.d.):
Bias is a tendency to have partial views toward a subject or person.
Prejudice is a disapproving or negative attitude that is not rooted in fact or accurate information.
Stereotype, according to the sociological definition, is a uniform image that ...