Cultural & Linguistic Competency and Implicit Bias
Through the 2022 passing of California Assembly Bill No. 1195 and Assembly Bill No. 241, it is the stated intent of the CA State Legislature to encourage physicians and surgeons, continuing medical education providers located in this state, and the Accreditation Council for Continuing Medical Education to meet the cultural and linguistic concerns of a diverse patient population through appropriate professional development.
As an organization conducting a continuing medical education activity and operating in the State of California, the Western Angiographic & Interventional Society is required to inform faculty, speakers and learners about cultural and linguistic competency and implicit bias. Accordingly, portions of the annual WAIS program will reflect on
- patient populations impacted by the WAIS program to best determine how cultural and linguistic factors should be addressed.
- disparities in care affecting the patient populations impacted by the WAIS program, and the role implicit bias plays in these disparities.
WAIS STRATEGIES TO ADDRESS C&LC and IB:
- Invite faculty and speakers that reflect ethnic and gender diversity.
- Include presentations that provide examples of how implicit bias affects perceptions and treatment decisions of clinicians, leading to disparities in health outcomes.
- Include presentations that address how unintended biases in decision-making may contribute to health care disparities by shaping behavior and producing differences in medical treatment along lines of race, ethnicity, gender identity, sexual orientation, age, socioeconomic status, or other characteristics.
DEFINITIONS & DISCUSSIONS:
Implicit Bias - the attitudes or internalized stereotypes that affect our perceptions, actions, and decisions in an unconscious manner, exists, and often contributes to unequal treatment of people based on race, ethnicity, gender identity, sexual orientation, age, disability, and other characteristics.
- Implicit bias contributes to health disparities by affecting the behavior of physicians and surgeons, nurses, physician assistants, and other healing arts licensees.
- Evidence of racial and ethnic disparities in health care is remarkably consistent across a range of illnesses and health care services. Racial and ethnic disparities remain even after adjusting for socioeconomic differences, insurance status, and other factors influencing access to health care.
- African American women are three to four times more likely than white women to die from pregnancy-related causes nationwide. African American patients often are prescribed less pain medication than white patients who present the same complaints, and African American patients with signs of heart problems are not referred for advanced cardiovascular procedures as often as white patients with the same symptoms.
- Implicit gender bias also impacts treatment decisions and outcomes. Women are less likely to survive a heart attack when they are treated by a male physician and surgeon. LGBTQ and gender-nonconforming patients are less likely to seek timely medical care because they experience disrespect and discrimination from health care staff, with one out of five transgender patients nationwide reporting that they were outright denied medical care due to bias.
Cultural Competency - a set of integrated attitudes, knowledge, and skills that enables a health care professional or organization to care effectively for patients from diverse cultures, groups, and communities. At a minimum, cultural competency is recommended to include the following:
- Applying linguistic skills to communicate effectively with the target population.
- Utilizing cultural information to establish therapeutic relationships.
- Eliciting and incorporating pertinent cultural data in diagnosis and treatment.
- Understanding and applying cultural and ethnic data to the process of clinical care, including, as appropriate, information pertinent to the appropriate treatment of, and provision of care to, the lesbian, gay, bisexual, transgender, and intersex communities.
Linguistic Competency - the ability of a physician and surgeon to provide patients who do not speak English or who have limited ability to speak English, direct communication in the patient’s primary language.