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Med Students Unaware of Their Bias Against Obese Patients
An anonymous reader sends news of a study which found that "two out of five medical students have an unconscious bias against obese people." The study, published in the Journal of Academic Medicine (abstract) examined med students from many different cultural and geographical backgrounds.
"The researchers used a computer program called the Weight Implicit Association Test (IAT) to measures students’ unconscious preferences for 'fat' or 'thin' individuals. Students also answered a survey assessing their conscious weight-related preferences. The authors determined if the students were aware of their bias by seeing if their IAT results matched their stated preferences. Overall, 39 percent of medical students had a moderate to strong unconscious anti-fat bias as compared to 17 percent who had a moderate to strong anti-thin bias. Less than 25 percent of students were aware of their biases. 'Because anti-fat stigma is so prevalent and a significant barrier to the treatment of obesity, teaching medical students to recognize and mitigate this bias is crucial to improving the care for the two-thirds of American adults who are now overweight or obese,' Miller said. 'Medical schools should address weight bias as part of a comprehensive obesity curriculum.'"
"Doctors are more likely to assume that obese individuals won’t follow treatment plans"
The primary goal of our treatment plan is often to get them to lose weight to cure their hypertension and type 2 diabetes. It's not a bias if you see the same patient in clinic every few months for years and they continue to gain weight and ignore your recommendations.
**** ********* M.D. , PGY-4 Resident
*Are* they less likely to follow treatment plans? It stands to reason that someone who won't do what's necessary for his health in one area might be less likely to do so in another area as well.
Studies have shown that the most common assumption is that fat people are lazy, undisciplined, unwilling to work hard, etc. -- not just in terms of health choices. Your comment is playing directly into that bias.
I think this bias, like most, actually does have some relationship to reality -- i.e., a greater percentage of fat people are likely to have these traits than others.
HOWEVER -- pre-judging an individual on the basis of a single characteristic is the very definition of "bias."
Even if 90% of obese people are lazy bastards who won't even try to listen to their doctor's advice (and I don't think the number is that high), that does not excuse a doctor who provides inferior treatment to the other 10% because of assumptions.
If the doctors' assumption is accurate, it's not bias in the sense implied.
That's like saying -- If a black person is driving around a rich neighborhood, he must be looking to steal something -- because "black people are more likely to commit crimes" is an "accurate" statistic.
Even if X is often correlated with Y, it doesn't justify the assumption that X always implies Y. When dealing with healthcare, these sorts of assumptions can literally be deadly, such as when a physician fails to search for secondary contributory causes of obesity in a particular patient because the assumption is just that the patient must be a lazy bastard who can't follow directions.