Hitting a Nerve

Bias and knowing too much about your patient



Years ago, I had a colleague who’d once worked for the prison system, treating people who were some of the more dangerous elements of society.

Once I asked if he’d ever gotten curious about what they were in for. He answered that, while he was always curious, he never asked. He felt as if knowing might prejudice his care. Since a key part of being a doctor is being impartial and objective, he was afraid that knowing about their previous heinous behavior would make him less concerned about treating them properly. And I agree.

Dr. Allan M. Block

Dr. Allan M. Block

When I was a younger doctor, I’d sometimes Google patients. I’d be curious about their backgrounds, or I wanted to see if there was anything on their social media I should be aware of they hadn’t told me. Maybe something like “I scored 20 percs off a neurologist today!”

I stopped after a while, and haven’t done it since. I never saw anything that would affect my treatment plan. I did, however, often learn about their political and religious views, some of which were distasteful to me. I respect anyone’s right to have an opinion, but that doesn’t mean I have to agree with them.

Like I’ve written before, I specifically avoid any discussion of religion or politics with my patients because doing so can lead to antagonism and dislike, with the potential to impact my objectivity.

The same can be said about what else you might learn online: their habits and hobbies, unflattering pictures, stories about their backgrounds, etc. All of those things can, in the right circumstances, lead to a bias against them. Perhaps it may just exist subconsciously, but it’s still there. A recent Medscape report noted the number of physicians who admitted having biases against patients, as well as the things that can trigger our visceral reactions: emotional state, weight, and intelligence, to name a few. We try hard to overcome negative feelings to provide proper care, but are still human and 100% objectivity is often difficult.

To me, Googling a patient became the same thing as asking inmates what they’d been locked up for: You learn things about them that might change how you view and care for them.

The only way to effectively treat patients is to see them as just people, like yourself. Knowing too much about their background that isn’t medically relevant is just asking for trouble.

I’d rather know less and be more objective.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

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