Assessing Implicit Bias in Dermatology

Speakers: Jacob Beer MD. Jeanine Downie MD

Jacob Beer MD: Hi everyone. I'm Doctor Jacob Beer. I'm a second year dermatology resident at the University of Miami. And I'm excited to talk to you all about our new article Assessing Implicit Bias in Dermatology. Here, we surveyed dermatologists to assess for biases and perceptions that could ultimately impact patient care. We stratify dermatologists based on geographic location, Fitzpatrick's skin type, and ethnicity and assess how dermatologists felt their training prepared them to ultimately provide culturally competent patient care.

Jeanine Downie MD: Hey, I'm Dr Jeanine Downie talking about my paper in the JDD on implicit bias. So why is this important to me? I am a board-certified dermatologist. I practice out of Montclair, New Jersey. I am African American female dermatologist as you guys can see. So in terms of dermatologists in this country, 3.4% of them are Black, about 1.5% of those are women and 2% of physicians here in the United States are female and African American. So I'm 2% of 1.5%.

Jacob Beer MD: There were a number of key takeaways from this article. The first was that most dermatologists noted a need for improvement in training for different aesthetic treatments on darker skinned patients, improved trainings on communication skills to address minority patients concerns and also enhanced need for residency training on cultural competency. The second takeaway is that skin of color dermatologists noted with a higher frequency and need for enhanced training on cost-conscious care related to aesthetic conditions. And then finally, we noted a gap in perceptions among skin of color dermatologists and non-skin of color dermatologists. And within that gap, we noted that 68% of skin of color dermatologists felt that they had adequate training to manage patients with skin of color. Whereas 80% of non-skin of color dermatologists felt that they had adequate training.

Jeanine Downie MD: What excites me about this topic is possibilities. I feel that as an African American physician, I certainly have had my share of sexism and racism directed towards me. So those things need to be acknowledged and we need to move forward and realize that we're treating patients, we're treating human beings. So we need to meet each other at our humanity. Think about what our preconceived notions are and move forward so we can be the best doctor for each and every patient, not just patients of our own skin type, but each and every patient at all times. And quite frankly, for some of us physicians that could be a matter of life or death.

Jacob Beer MD: Our study really lays the groundwork for further extensive studies on implicit bias within dermatology. Of note, we found that about half of the dermatologists that we surveyed thought that there needed to be an increase in diversity in clinical trials, which could suggest an underlying implicit bias among providers. And what's more important is that we note solutions and possible next steps could help remedy some of these implicit biases starting with implicit bias screenings for providers, staff, and management, as well as implementing the Harvard Implicit Bias Test at various milestones throughout medical training, including medical school and residency, as well as for nurses and for staff in medical practices.

Jeanine Downie MD: So I think we need more diversity to represent all patients and all skin types, races, religions, ethnicities, all of it. And I think that it's important because we can provide good care to those that are not our same color, religion or race. But I think it is important to represent all races, religions, colors, and creeds. So I hope that you enjoyed my video and I thank you. And again, this is Dr. Jeanine Downie, Image Dermatology, Montclair, New Jersey. Please read my JDD article on implicit bias.