Addressing bias in healthcare: Confrontation as a tool for bias reduction and patient and provider self-advocacy

The individual biases of health-care providers may be one contributor to the persistence of health disparities. Evidence suggests that health-care professionals, like members of the broader community, hold implicit biases, and furthermore that these biases are related to the quality of doctor-patient interactions. In this chapter, we propose that patient confrontation of physician bias may serve as a self-advocacy tool that reduces physician bias and improves quality of patient care. We discuss unique challenges and considerations for effective confrontation in the health-care setting. We also discuss the possibility of confrontation as a strategy that health-care providers may use to reduce expressions of bias from their patients. Finally, we discuss evidence on whether confrontation-based training effectively reduces bias in this setting.