3min chapter

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59. Healthcare Disparities in Rheumatology

ACR on Air

CHAPTER

The Role of Mindfulness in Propagating Healthcare Disparities

"I think we need to kind of take a step back and really think about where our biases are coming into play," she says. "If you see that there may be a bias that's leading to a poor outcome, well, then we need to fix said bias,. right? It's not only about being aware of it, it's then subsequently addressing it." 'We have jobs that potentially give us that flexibility. Many people do not'

00:00
Speaker 2
And tell me about sort of bias and the role that the clinician has in perhaps unexpectedly propagating these disparities. And, you know, we've been, you know, drilling into our heads, you know, over the past couple of years about unconscious bias. And I wonder to what extent does that also play a role in perpetuating some of these healthcare disparities? I mean,
Speaker 1
I think it can play a large role, right? And I think that it's the discussions, and I think the mindfulness of providers, or at least places where I tend to work, definitely, I think has made us a little bit more mindful on patients' potential lived experience, right? So, you know, I think that if a patient missed many, many appointments before, it'd be like, oh, they're so not adherent. They never come to the clinic, etc. Whereas I'm hoping, or at least I'm seeing, again, where I tend to work, you know, providers being a little bit more mindful to say, you know, hey, let's find out why, right? Let's find out why this person's not coming. How do we help them? How do we, you know, see if we have resources to make it available? And now, I tell her how we could potentially do that, right? If we have a person that works a job that, you know, works an hourly wage, for example, that doesn't necessarily get time off to go to the office to be seen. And it's just a quick, you know, high in buy for a biologic and they don't necessarily need a physical exam, especially if they're doing really, really well. Well, then maybe they can take that 15 minutes to do their telehealth visit in the break room, right, as opposed to coming to the office, right? You know, us not rolling our eyes when, you know, the patient potentially maybe needs a letter to prove to work, right, that they were actually at the office. You know, we have jobs that potentially give us that flexibility. Many people do not, right? Or thinking about, you know, the access to just get to our clinics. Alan and Anandaraja at, you know, Rochester, he created this program called IQ Lupus, and it's a multi-disciplinary model, a care model for Lupus patients. And one of the first things that he did was realize that, you know, patients couldn't get across Rochester to come to them at the University Hospital, right? So he moved the clinic to where the patients actually were, and then all people can now make their appointments, right? So if we start to really, you know, kind of not assume our biases to assume, well, if they really want to come, they're going to come, right? Well, no, that's just not going to happen. You know, I think we need to kind of take a step back and really think about where our biases are coming into play and, you know, make those interventions. So I think while it's important to acknowledge our biases and that biases may exist, that's literally step one. Step two is once you know better, you need to do better, right? So if you see that there may be a bias that's leading to a poor outcome, well, then we need to fix said bias, right? It's not only about being aware of it, it's then subsequently addressing it.

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