Overcoming unintentional bias in the healthcare hiring process

How much are we ruled by the decisions we make about our patients, our office staff or our fellow professionals purely based on longstanding and arguably innate biases? How does that color the treatment, the fairness and the daily interactions we have or the hiring decisions we make? 

Steve Marsh, President of the Executive Search Division of The Medicus Firm, recently spoke to MGMA Sr. Editor Daniel Williams on the MGMA Insights podcast about strategies for overcoming those biases and building a more inclusive workplace.

“When you look at best practices for diversity, hiring and inclusion, it’s critical that everyone understands what (bias) is,” he said, “and how it plays a part in basically everything we do – not only in the workplace, but on a personal level.”

‘We’re not even aware of it’

Marsh described unconscious or unintentional bias as stereotypes or beliefs that can potentially affect our actions in a discriminatory manner. “And we’re not even aware of it,” he said. Those prejudicial but often almost subconscious cues can be traced back to one’s upbringing and environment or individual experiences, but don’t necessarily apply to everyone.

These biases “allow you to determine or have the belief that any interaction with someone who fits into a particular category is going to create the same result,” he said. “It’s something that’s really being tackled now by a number of large companies, and it’s really come to the forefront, though it’s been around for decades.”

A lengthy list of biases

Marsh has spent his entire career in provider recruitment, a quarter century’s worth of recruiting clinicians and setting them up in all 50 states. That experience has given him a unique perspective on the biases that shape our decisions and frequently make us unconsciously choose one candidate over another, based on gender, race, age, sexual orientation, economic background, or even health or political status (studies have found that there are as many as 150 different unintended or unconscious biases).

Marsh said bias often emerges when hiring committees, in particular, aren’t able to quantify why a potential employee just misses the mark.

“You’re interviewing, you’ve got a search committee, and you hear, ‘I just don’t think that person is a fit.’ And that search person can’t define ‘fit,’” he said. “It’s just something that they felt when they met or reviewed somebody’s information. That’s always an alarm bell that should ring and let you know that unintended or unconscious bias has crept into the evaluation process. That’s why when you tackle this problem, it’s really important to allow people to know that it exists, but also to try to focus everything on (candidate) competency, as opposed to those feelings.”

By highlighting competency, Marsh said, a workplace can naturally become more diverse, rather than by forcing the issue.

“I’m not only talking about the things we often think about in diversity hiring, some of those protected categories – race, religion or gender,” he said. “It’s important to understand that a diverse workplace is not only a good mix of everybody in those categories, but also a good mix in terms of how they think. 

“When we started our firm, my two partners and I would have some pretty spirited meetings, and one of our favorite quotes was, ‘If two partners think alike, one is not necessary.’ We felt that the fact we had different viewpoints helped us evolve as a company and grow.”

Striking a balance

Marsh said an ongoing societal focus on equality and equal representation has also begun to flavor the way employee and manager leadership training is conducted, again with an eye to eradicating bias. That presents itself, he said, in learning “things like how to set up a meeting as a leader, making sure that everyone’s voice is heard. Is a meeting just a monologue, where the leader simply dictates what’s going on, or are meetings run where everyone has a voice and is allowed to contribute ideas, no matter what the outcome might be? And then, are those ideas taken seriously?”

And as the American political landscape has become more divisive than ever, Marsh said employers have to strike an even balance to not let personal views creep into the hiring process – especially if it’s based on the seemingly un-erasable world of social media, where a post a decade ago might cost you a potential job. 

“If you’ve posted your opinions on social media, you are also creating a perception of yourself, and that perception exists,” he said. “It’s not just something you can delete a post or two – you have to realize that what you posted maybe seven or eight years ago is certainly going to create an unconscious bias. You might have to answer some questions about those and do the best you can to navigate.” 

The issue goes both ways, Marsh also noted.

“If you are in a truly inclusive culture, you’re going to be able to accept that other peoples’ viewpoints along political lines are different,” he said, “but you can still work with that person to advance the goals of the organization.”

Hear Steve Marsh discuss unintentional bias starting at the 2:10 mark of this MGMA Insights podcast


ADDITIONAL RESOURCES:

• "Implicit bias: the importance of self-awareness for patient care and in the workplace" (MGMA Stat)
• "Thoughts on interviewing: You, attorneys, staff and physicians" (MGMA Insight Article)