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In order to understand the need to minimize the effects of social perception we must understand what it is and its implications.
4. Unconscious biases, also known as implicit biases, are the underlying attitudes and stereotypes that people unconsciously attribute to another person or group of people that affect how they understand and engage with a person or group.1 Bias is a function of how our brains are wired to deal with all of the information that we are bombarded with daily. It’s how we take in information and make sense of it.
5. The implications are significant. The brain categorizes people and experiences as a way of organizing our thought processes. Our brains put that information into categories and people into social groups. Once categorized, we form beliefs and attitudes about those individuals. Those categories form both conscious and unconscious biases. It shapes what we see, think, and do. Those social perceptions can be inconsistent and prejudicial. Once we form wrong impressions, they are prone to live on.
6. If the goal is to hire the best candidate, then the hiring process needs to actively work to minimize the effects of social perceptions. First acknowledge the problem. This involves teaching or training hiring manages about hiring biases. When the problem is acknowledged, then a solution can be achieved. Next, you need to “level the playing field” by “ensuring you are focused” on your candidate’s specific qualifications and talents, not surface “demographic characteristics,” says Bohnet.2. One method to accomplish this is by having a blind resume review to avoid gender, age, race and other biases. By which we mean remove the candidate’s name, age and other potentially discriminating information from the resumes before you go through them.3. Human nature has a tendency to connect with others who share similarities. Instead of trying to hire for “culture fit”, someone with similar backgrounds, experiences and interests, hire for a “culture add”, someone who would contribute to the team and help you grow. Additionally, standardize the interview. Standardize the interview questions and the post-interview debrief so that all assessors follow the same framework when assessing and ranking candidates.3
7. The military has basic requirements to join. Once those basic requirements are met anyone if eligible to enlist regardless of social perception. With that said, the military has a very diverse cohort, however, at the upper leadership levels the diversity diminishes significantly, presumably due to social perceptions and hidden barriers. The Massachusetts Army National Guard (MA ARNG) understand that diversity enhances cohesion, raises the standard and enriches cultural competence. The MA ARNG has made a commitment to achieving it at all levels, however they have struggled to ensure senior leadership opportunities equitably. As part of the MA ARNG commitment to diversity they have has created standard interview questions for promotions and position interviews. The Army is addressing the problem with an array of initiatives. Among them: removing photos of officers from personnel files so promotion boards are less aware of race.4
8. At the end of the day, eliminating hiring bias makes good business sense for the company’s bottom line. Plus, removing hiring bias will help you achieve a fair hiring process and reduce the failure rate for hiring which can be up to 50%.3
9. References
10. 1. Reiners, B. 12 Unconscious Bias Examples and How to Avoid Them In The Workplace. August 12, 2019 Updated: September 1, 2020 https://builtin.com/diversity-inclusion/unconscious-bias-examples
11. 2. Knight R. 7 Practical Ways to Reduce Bias in Your Hiring Process. Harvard Business Review. June 17, 2017. Assessed October 18, 2020
12. 3. Johnson, A. 11 Ways to Reduce Hiring Bias. Harver website. Posted Jan 17, 2019. Accessed October 18, 2020. https://harver.com/blog/reduce-hiring-bias/
13. 4. Brook, T. Where Are The Black Officers? US Army Shows Diversity In Its Ranks But Few Promotions To The Top. USA Today. Posted September 1, 2020. Accessed October 21, 2020. https://www.usatoday.com/in-depth/news/politics/2020/09/01/military-diversity-army-shows-few-black-officers-top-leadership/3377371001/


Single payer healthcare systems, and other government attempts to ensure universal coverage for citizens, tend to result in high life expectancies while remaining cost-effective. However, the cost ceilings that make this possible not only affect prescription medications but also the availability of advanced imaging modalities and physician compensation. As a result, countries with otherwise robust healthcare affordability may experience prolonged waiting times for advanced imaging, elective procedures, and even primary/specialty care visits.
In places like Germany, where in 2015 general practitioners (GPs) could hope after three years of experience to earn 5000 euros monthly (then, the equivalent of nearly 6000 dollars), higher salaries in the United States and other European countries tempt physician emigration.1 In Canada, the average time between a GP referral to a specialist and eventual visit was 78 days between January 2014 through December 2016.2 Compare this to the Merritt Hawkins 2017 Survey of Physician Appointment Wait Times which identified Boston, Massachusetts as the worst among 15 major metropolitan areas in the U.S. for specialty follow-up with an average wait of 53 days for a new patient appointment.3 Finally, consider Japan, wherein the number of physicians, coupled to the unique challenges of terrain, have created a healthcare system in which most individuals do not have a GP despite easy access to secondary healthcare services.4 As a result, many patients in Japan interested in routine maintenance of their chronic health conditions require their entire history reviewed by a novel physician during subsequent wellness exams. This trend is improving but consumes much of a physician’s time in an otherwise basic healthcare encounter.
It is important to remember that there is no perfect healthcare system. The only way to create a more egalitarian process of delivering healthcare in the United States is to study our wins and losses as compared to our peer nations.

1. Wáng YX. Income Of Medical Doctors In Germany. Quant Imaging Med Surg. 2015;5(3):488. doi:10.3978/j.issn.2223-4292.2015.02.05
2. Liddy C, Moroz I, Affleck E, et al. How long are Canadians waiting to access specialty care? Retrospective study from a primary care perspective. Can Fam Physician. 2020;66(6):434-444.
3. 2017 Survey of Physician Appointment Wait Times. Merritthawkins.com. https://www.merritthawkins.com/news-and-insights/thought-leadership/survey/survey-of-physician-appointment-wait-times/. Published 2017. Accessed October 20, 2020.
4. Kato D, Ryu H, Matsumoto T, et al. Building Primary Care In Japan: Literature Review. J Gen Fam Med. 2019;20(5):170-179. Published 2019 May 13. doi:10.1002/jgf2.252

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