When Provider Bias Becomes Lethal, High Utilizers in the Healthcare System-View Recording

Video Transcription

Video Summary

In this session titled "When Provider Bias Becomes Lethal," various speakers addressed the critical issue of how provider biases can dangerously impact patient care, particularly in psychiatric services. The session was spearheaded by Kelly Klein, Medical Director at the Vermont Department of Mental Health, alongside other notable medical professionals. The discussion initially centered on a case study of a young woman with a complex psychiatric history, whose recurrent hospital visits and severe self-harm were overshadowed by providers’ biases, ultimately leading to a fatal overdose. The session underscored the harm of "instant countertransference," a provider’s immediate emotional reaction to a patient, which can lead to detrimental assumptions and inadequate care practices.<br /><br />Further explorations included a high-utilizer patient dealing with alcohol withdrawal, emphasizing the importance of objective assessments over subjective biases. The detrimental impact on healthcare systems and patient outcomes due to such biases was highlighted, noting that 5% of patients lead to 50% of costs in Medicaid. Strategies for reducing burnout among staff facing such high-pressure cases were also presented.<br /><br />Closing discussions revolved around case studies and personal anecdotes to emphasize how biases, both implicit and explicit, affect clinical decision-making. Participants were encouraged to engage in continuous education, seek peer consultations, and remain aware of personal biases to ensure a standard of care that is just and equitable for all patients. The session called for a conscious effort to change perceptions and behaviors within medical practices to prevent bias from becoming lethal.

Keywords

provider bias

patient care

psychiatric services

Kelly Klein

Vermont Department of Mental Health

instant countertransference

high-utilizer patient

alcohol withdrawal

Medicaid costs

burnout

implicit bias

clinical decision-making