Symposium Addresses Bias Against Health Care Providers

The March 10 event was co-sponsored by the Jacobs School and the VA Western New York Healthcare System. The goal of the symposium was to allow providers to share stories and be empowered to address solutions to bias.

Archana Mishra, MD, clinical associate professor of medicine in the Division of Pulmonary, Critical Care and Sleep Medicine, has experienced bias firsthand in her three decades in medicine.

“As a brown, overweight woman, who has spent my entire professional career globetrotting and switching between medical disciplines, facing ‘othering’ personally was something I accepted as the norm,” said Mishra, a pulmonologist and critical care physician who works with patients in the intensive care unit at the Buffalo VA Medical Center. “I thought ignoring bigoted comments and ‘rising above’ the situation was what I needed to do as a professional, especially when it came from patients who themselves were suffering and vulnerable.”

Bias, whether explicit or implicit, can take a toll on those who face it.

“This is not always a simple or even a comfortable topic. And we don’t want to stay silent. It’s a pervasive challenge,” said keynote speaker David Kountz, MD, associate dean for diversity and equity at the Hackensack Meridian School of Medicine, vice president of academic affairs at Jersey Shore University Medical Center and co-chief academic officer for Hackensack Meridian Health.

“Microaggressions will seem innocent, unless you are the recipient of them, and then it’s not so innocent. The consequences of microaggressions can be quite significant — anxiety, depression, sleep disturbances, diminished confidence,” said Kountz, who earned his medical degree in the early 1980s from what was then the UB Medical School.

In many instances, colleagues may not realize they are doing anything wrong.

“If we can step in with colleagues, that’s really important. That helps the colleague understand and it takes some pressure off the individual who may be in a power position where they don’t feel they can speak up,” Kountz added.

Any bias toward trainees is something those in authority can not let stand.

“When it comes to prejudice toward one of my trainees, I address it right away,” Mishra said. “If you’re there, the confrontation can be in a calm manner, it doesn’t have to be hostile. If you aren’t there, the first thing to do is believe the person who tells you that, because having that support from your supervisor, from your institution, means the world.”

Nearly half of the physicians in a recent national survey have had patients request a different clinician because of the provider’s personal characteristics, such as race, nationality or gender, according to Mishra.

“Experiences such as these with irrational biases can get in the way of patients’ care,” Mishra said. “Given the paucity of resources for helping providers deal with these situations, it does contribute to the rising epidemic of burnout.” 

That burnout can have a profound effect on health care.

“We all have the responsibility to be allies. It’s easy to hear something and let it go, to say it didn’t affect us, she needs to have a tougher skin, etc. But why? What’s wrong with educating a colleague in a respectful manner and appreciating that this has such an important impact on the person who is the recipient of the bias,” Kountz said. 

“I get it that it’s not easy, I get it that there are these power issues. But it can be done in a respectful fashion, and it must be done. Otherwise we are going to see a revolving door of our colleagues coming and going from our organizations because they feel they are not being supported,” Kountz said.

“This is a subject that takes a toll on health care teams and on patients. Bias toward providers is a very important topic,” said Roseanne C. Berger, MD, clinical associate professor of family medicine. “I appreciate Ursuline R. Bankhead, MD, and her committee for coordinating this program.”

Bankhead is psychological chief/assistant chief of mental health and chair of the health equity committee at the Buffalo VA Medical Center.

“I applaud everyone who took part in this symposium, which addressed an important topic,” said Allison Brashear, MD, UB’s vice president for health sciences and dean of the Jacobs School. “Anything that hinders a provider from giving the best possible care hurts us all.”

David A. Milling, MD, senior associate dean for student and academic affairs, introduced the keynote speaker.

Other panelists included:

• Shondra Brown, nurse practitioner with VA Western New York Healthcare System
• Thomas Conboy, MD, a psychiatrist practicing in Western New York
• Jeanea Hundley, MD, a Jacobs School alumna and medical director for Anthem, Inc.