Doctor Bias Can Put Patients at Risk

In June of 2022, the Joint Commission issued a Sentinel Event Alert warning that a physician’s cognitive bias creates a risk of diagnostic overshadowing, or, the attribution of symptoms to an existing condition rather than a potential alternative condition. What this means is that a clinician may reach a conclusion about the cause of a patient’s condition based upon not only pre-existing conditions or disability but also because of their own doctor bias. This is based on factors such as race, ethnicity, language spoken, sexual orientation, gender identity, geography, health insurance, access to health providers and pharmacies, and other social factors thought to influence health.

These factors can influence a doctor’s evaluation and can result in a biased approach to care. This negatively impacts the health care of patients in these groups and possibly put them at risk. An initial misdiagnosis may not only have a significant impact on the patient’s immediate treatment, but may influence their treatment for years to come.

Steps To Help Stop Doctor Bias

As a result, the Joint Commission recommended several steps to help doctors, and the hospitals and professional groups that employ them, recognize and address potential bias and resulting diagnostic overshadowing to reduce the health disparities of those impacted.

These recommendations include creating an awareness of the risk of diagnostic overshadowing and provide training and educational programs focused on recognizing and responding to these issues, including:

• Improved listening and interviewing approaches to better understand the concerns and complaints of each patient and encourage shared decision making;
• Collect data about pre-existing conditions and disabilities and provide it as a “prompt” in electronic medical records for the clinician;
• Acknowledge the systemic discrimination that results in health care due to sexual orientation, race, economic status, immigration status among other factors and consider these individual factors and how they may influence individuals’ medical care; and
• Review the clinician’s organization’s ADA compliance mindful of how a patient’s individual abilities may influence medical care, to assure the needs of the disabled population are met.

The Joint Commission’s Sentinel Event Alert goes a long way towards identifying the impact of bias on the diagnosis and treatment of those individuals in disparate patient groups. Its recommendations are critical to reducing the influence of bias and diagnostic overshadowing that can lead to wrong diagnoses and treatments.

It is critical that health care providers recognize these risks, but patients too need to advocate or have family or close friends advocate for them when seeking medical care.