Removing bias in healthcare to improve inclusive patient recruitment
It might be hard to admit, but we’re all biased in one way or another — would you agree? We all have our own opinions based on influences over the years, and can be biased towards them to make decisions without considering other possibilities. More often than not, it doesn’t come from a place of bad intent and normally wouldn’t cause an issue in our everyday lives. However, it starts to become an issue when bias is found in healthcare.
In short, bias exists within the healthcare industry — racial bias, gender bias, age bias, and more. Not only does this affect the care that people receive from their GP, but it can also extend to patient recruitment for clinical trials. This can contribute to a lack of diversity and inclusion, as well as poorer health outcomes for certain groups.
Why we need to remove implicit bias in clinical trials
A patient should not expect to receive a lower standard of care because of their race, ethnicity, age, gender, or any other characteristic. However, a lot of evidence shows this is happening, and that unconscious bias exists in healthcare today.
Maybe it’s a case of patients receiving a bit more time and attention if their healthcare provider (HCP) relates well to them, even though the HCP is unaware. Or maybe the HCP is unintentionally speaking to some patients differently, because of their beliefs about social class. The truth is, it might not be intentional, but HCPs can treat their patients differently based on their gender, the colour of their skin, their age or socioeconomic status, rather than seeing them as individuals.
As a result, some people can receive different types of tests or treatment based on their HCP’s assumptions. For example, HCPs can put too much focus on a patient’s family history, due to their implicit bias regarding ethnicity and hereditary diseases, rather than being focused on the patient’s individual health status and personal medical history.
The bias of HCPs could affect patient recruitment in clinical trials due to their assumption that a certain patient would not want to take part. Or bias within study sponsors or those who are creating the patient recruitment materials could lead to a lack of inclusive patient-facing materials in clinical trials or cultural considerations, such as producing the materials in other languages. This implicit bias can affect patient outreach, and result in a lack of diversity in the communities engaged with. As a result, those who take part in the clinical trial are not representative of everyone, and we can’t be sure that the treatment will be safe and effective for everyone.
The issue at hand in clinical trials
In short, people’s health outcomes are affected because of HCPs’ bias. And as societies become more and more diverse, HCPs will need to effectively communicate with and provide care for patients whose ethnic or cultural background may be different to their own.
We need to take a different approach, encourage a different way of thinking, and help change people’s perspectives. Because if this implicit bias continues to exist, so will health disparities across different populations.
How to remove implicit bias in clinical trials
#1 Acknowledge it
The first step is to simply acknowledge that bias exists. Make the unconscious, conscious. Talk about it and raise awareness. For example, did you know that one study found over 80% of healthcare workers often or sometimes found it more difficult to engage with or treat patients from cultures different to their own? Sharing this statistic will raise awareness in itself, showing that HCPs are not alone in this, and that we need to come together to address it.
#2 Report issues and show accountability
There might be a place where people can share their negative experiences and report issues, like filling in a survey. But, that survey should then come with a follow up, showing accountability and actions towards a resolution.
#3 Improve education and experience
Perhaps if people were more aware of cultural and individual differences earlier on, this could help to alleviate bias in the future. For example, medical and nursing schools could include communicating with people from different backgrounds on the curriculum, and students could experience spending time with minority communities to gain a better understanding of health inequities.
#4 Consider cultural safety training
Cultural safety training allows people to evaluate and critique their individual attitudes, biases, stereotypes and more. It aims to help people become more self-aware and communicate effectively with all types of people, to ultimately provide equal care to everyone.
When we start to see people as individuals and understand that everyone is different, we can communicate more effectively with all ethnicities, genders, ages, and more, to ultimately improve patient recruitment in clinical trials and ensure better health for all. Reach out to us at firstname.lastname@example.org if you want to discuss more about cultural safety training or improving your patient recruitment.
As a failed neuroscientist, Ash has sought to bring meaningful change to the healthcare industry ever since by working at some of the biggest agencies in the world, his career spans more than 10 years. His expertise lies in creative communications, patient engagement, diversity & inclusion and patient recruitment strategies for clinical trials – with the ultimate goal in life to make clinical trials more human. When he isn’t doing all that, he’s anticipating the latest movie, expanding that love to screenwriting or trying to be creative.