My newsfeed is blowing up about Alton Sterling in Baton Rouge today. Violence and guns have nothing to do with anything around here, but racism touches all corners of the world, including the health field.
We’ve called our attempts to quell racism in the health care field “cultural competency” classes. I’m sure you’ve probably been forced to take one at some point and listen to someone terribly boring give a lecture on how you shouldn’t let your racist flag fly on the job, blah, blah, blah, whatever. (The topic is truly important, but no one ever listens to those lectures, let’s be real.)
But I’d like to expand on the thought of “cultural competence” into being aware of your own biases and how those biases effect you on the job. Biases are a broader umbrella including racism, ageism, gender or religious or cultural discrimination.
APTA has put out a great article on recognizing and reducing the more obvious biases regarding the LGBTQ population in their little magazine PT in Motion. And this doesn’t just apply to the pelvic mafia AKA “Women’s” health group either. I just got mine in the mail today. (I’m having technical issues with my mouse today and can’t quite figure a way to get a link to that on here. Will add it when I get my tech under control.)
I will also invite you take this little cultural competence quiz for health care professionals. I got 13/23. I thought I’d do better than that!
The first step to doing something about your negative biases is to do recognize you have one and that it needs to change. Why is this of particular importance for health care workers? Personally, I believe all peoples have a right to good health and that having access to competent health care providers is key to good health. And health care providers cannot be competent if their biases interfere with their ability to provide quality care. So, if you recognize you have a problem, you can then do something to change that bias problem or at least take yourself out of the care team for that person you are biased against, so you do not negatively impact that person’s right to good health.
Once you have recognized you have a negative bias and are ready to change, I think the first step toward making that change happen in humanizing your bias. Actually meet and talk to someone that falls into the category in which you hold negative bias. For me, that always breaks that wall down. Adding a human face that you can call a friend into that category of people you feel negatively toward chips away at the barrier. Once you realize those people are just that: people, you can move on to perhaps adding them into the “human” category that have rights to good health and therefore your health care provider services.
I’ll give you an example from my own walk.
During one of my clinical rotations in PT school, I was doing clinical field work at a small outpatient clinic with 2 physical therapists. I was under 1 therapist, but the other therapist was planning on going out of town for about a week. She was seeing several women’s health clients and asked if I would be willing to see them the week she was gone, as my clinical instructor was a male and the substitute therapist they were bringing in didn’t feel comfortable treating women’s health clients. She also mentioned that some of the clients were a little on the rough side and were also prostitutes. She explained that they were seeking out physical therapy because their dysfunction was impeding their ability to work… as prostitutes. She also mentioned that she felt like a lot of their dysfunction was more psych related due to the trauma of the nature of their work, but that by addressing their physical function, we were improving their psychological dysfunction too.
Woah woah, wait a minute. Time out. First of all, that “job” is totally illegal. I wasn’t sure I wanted to help a prostitute get back to work. Wasn’t it a good thing she couldn’t work at that “job”? I mean, I was brought up believing that porn and prostitutes destroyed martial relations and families. (I still feel this way.) I took a deep breath and said I wasn’t sure I could do it (I didn’t mention why), but that I would be willing to learn how to do the treatment and I would let her know after sitting in on a session or two if I’d be willing to do it that week she was out.
So I followed her through a few sessions with her women’s health clients. She never told me which ones were the prostitutes, but I had a good idea. Or at least I thought I did. But after meeting them all, I found they were all really just regular people that needed my help. I had knowledge and burgeoning skill that they really needed, because there was literally no one else to provide those services that week. So I did my best to put my biases aside and be a competent health care provider for all that week, including the prostitutes.
So, I challenge you too to identify your own biases. It may be hard to see them until you come face to face with them like I did with the prostitutes. But meet them head on when you do.