Hidden Bias

I don’t like having too many choices.  A few years ago, I wanted to get a bigger TV.  I just wanted to go into the store and come out with something in the 50-60 inch size.  I went into the store fully intending to buy a TV, yet I walked out of there with nothing.  Why? Because there were too many choices.  I could have made an easy choice if it was size alone, but the choices weren’t about size.  They were about features and gizmos and catch phrases for technology that I mostly didn’t understand.  This one had this and that one had that, and it was all too much for me to decide.  I ended up just giving my daughters my credit card and a price limit  and telling them to bring home something nice.

I needed a new dermatologist.  My aunt died of melanoma many years ago, so I am supposed to get an annual mole check.  I was going to one doctor for many years, but then he unexpectedly closed his practice, and I never got a new one.  The other day I noticed a new mole on my arm that wasn’t there before.  While it looked pretty innocuous, it spurred me to get back to having my annual checks.  To do so, I needed a new dermatologist.  I went to the hospital web site and there were almost twenty dermatologists to choose from.  Here’s where the problem came in. 

I would have been happy to take any one of them, but I had to choose one.  And it wasn’t a list of names, there were pictures.

I felt like I was suddenly part of a research experiment/focus group.  Who was most likely to be chosen (or not) and for what reason?  Which of their hands would I place my life in?

The older white man (Marcus Welby)   Should I take him as the trusted old time doctor or should I avoid him because he might be out of touch with the latest science and maybe behind his smile and good nature, be hiding a touch of dementia?

The middle aged Asian woman.  Should I choose here she might be super smart or should I avoid her because she might be harder to understand if she has a strong accent?

The young black doctor.  Should I take him because he may have overcome much to become a doctor or, is there a worry that he may be there only as a token?  Of all the doctors he is shockingly the only one from his race.

The young white man.  Should I take him because he may be up on all the latest info?  Or do I worry he is a rich kid who has everything handed to him on a silver platter and he may only have gotten into med school because his Daddy donated to the college hospital or is best friends with the Dean?

As each picture provoked multi responses in me, I wondered if I should just go “eeny, meeny, miny, moe?”

I ended up getting a referral from a doctor friend.  I called for the appointment without checking the name against the pictures.  I was asked if I minded being seen by a resident instead, and that was fine with me.

When I went for my appointment I was seen by both a resident and an attending, and I found them both very professional, and I was grateful for their time.  The mole indeed turned out to be innocuous.

Still the episode of reacting to the pictures troubled me because as much as I want to view everyone the same, the exercise brought out hidden biases, maybe biases that I may not act on, but ones that flashed into the control room of my brain, raising troubling questions.

It all made me wonder what people’s impressions are of me when I come through their door.  I am a very tall scraggly looking, long haired, mustached sixty-year-old white man?

Do I project experience?  Do they think I might have dementia?  Do I look kind?  Do they trust me with their lives?  Or do I scare them?  What biases do they hold toward me?

Hopefully, once I introduce myself and start caring for them, they feel okay about me being their provider.

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