Practical Steps to Identify
and Mitigate Implicit Bias

What is implicit bias?

Implicit bias refers to attitudes or stereotypes that influence how we think and act. This often happens without us realizing it. They may even conflict with our beliefs and how we see ourselves.1

It is human to make these sorts of assumptions, both positive and negative, about the people we encounter based on their behaviour and characteristics. Many healthcare settings are fast-paced and high pressure. In these environments, automatic responses can help us make quick decisions. However, these quick decisions can also lead to assumptions that are incomplete or inaccurate.

These biases often form over time through lived experiences, media and social messaging, and because they operate automatically, many people are not aware that they may have them.

The impact of bias in Canadian healthcare: Themes and statistics
  • Discrimination is a common experience: In 2024, 45% of racialized Canadians reported facing racism or discrimination within the previous five years, with 81% of those individuals experiencing multiple incidents.2
  • Gaps in preventive care: Bias can influence how and when care is accessed or provided. Bias can lead to delayed diagnoses in some instances. For example, research posted in late 2024 showed that breast cancer is diagnosed less frequently at Stage 1 among Black, Filipina and Indigenous women compared to White women, suggesting gaps in screening access or provider-patient communication.3  
  • Mental health impacts: Racialized Canadians who experience discrimination are twice as likely to report “fair or poor” mental health (24%) compared to other racialized Canadians (13%).4
Why implicit bias matters for caregivers

Many caregivers enter healthcare to help others and provide fair, compassionate care to others who need it most. Even with best intentions, implicit bias can influence how care is delivered. Bias does not mean a caregiver is doing something wrong on purpose. It reflects how the human brain processes information. Recognizing this can help create space for learning and growth. Implicit bias matters because it affects patient trust and communication. It can also affect health outcomes. When patients feel heard and respected, they are more likely to share information, follow treatment plans and return for further care and support. For caregivers, becoming aware of any potential bias is a step toward providing safer, more equitable care for all patients.

It is key to remember that implicit bias is not about blame, but rather about learning, reflection and future understanding. With the right tools and support, the impact of this bias can be reduced, helping to create a healthcare system where everyone feels respected and looked after.

Bias is human – not intentional.

Awareness creates opportunity for better care.

Common forms of implicit bias

Common forms of implicit bias

Understanding how bias shows up across different patient experiences is the first step. The next step is to know what to do.

Assumptions about pain:

A caregiver may unintentionally assume that some patients feel less pain, tolerate pain better or exaggerate symptoms based on race, gender or age. These assumptions can contribute to health disparities, lower trust and reduced access to care.

Assumption:
“This patient can handle
more pain”
Impact
Pain may be under-treated
or ignored
Perceived socioeconomic status:

A caregiver may adjust how they communicate they may speak more slowly, use simpler language or avoid detailed explanations with certain patients without checking their actual needs or level of understanding. Assumptions about a patient’s financial or social situation can affect how information is shared. Bias related to socioeconomic status can also influence assumptions about lifestyle choices, employment, housing stability or access to resources, which may affect the type and quality of care offered.

Assumption:
“This explanation is too complex”
Impact
Patient may feel talked down to or confused about care
Dismissing symptoms too quickly:

Physical symptoms may be labelled as “stress”, “anxiety” or “emotional” without a full assessment, especially patients from marginalized groups. When care providers are overworked or stressed, they are more likely to rely on bias. This can result in less empathetic care.

Assumption:
“These symptoms are most
likely due to stress”
Impact
Underlying health concerns
may be missed
Focusing on weight instead of symptoms:

A caregiver may assume that a patient’s health concern is mainly related to their weight, without fully exploring other possible causes. This can affect the type of care or treatment options that are discussed.  A 2015 survey found that a healthcare professional may recommend a patient to lose weight rather than providing treatment for their condition.5

Assumption:
“Weight is the main reason
for this symptom”
Impact
Other health concerns may be overlooked or diagnosed later than needed
Bias related to substance use and lived experience:

Patients who use substances, have a history of substance use of are perceived to be using substances may experience bias in healthcare settings. Caregivers may unintentionally assume that these patients are exaggerating symptoms, seeking medication for non-medical reasons or are less likely to follow treatment plans. This bias can be more common in pain management, where patients may be labelled as “drug-seeking” rather than receiving a full assessment of their pain or condition. These judgments can lead to delayed treatment, under-treated pain and reduced trust in care.

Assumption:
“This patient is seeking medication rather than care”
Impact
Pain may be under-treated or valid concerns dismissed

Practical steps caregivers can take

It is important that all people have access to the same levels of healthcare. The steps below can be useful in understanding whether implicit bias may be a factor. Reducing bias does not require perfection. It starts with small, intentional actions that support fair and respectful care.6

1. Pause and reflect

When time allows, take a moment to reflect before making assumptions or decisions around care.

Questions to ask:

  • Would I respond the same way if this patient were a different age, race, gender or body size?
  • Am I relying on a first impression rather than considering the whole picture?

Even a short pause interrupt automatic judgement. This can help reduce the impact of implicit bias and make all the difference.

2. Use consistent and structured approaches

Providing patients with a list of questions to ask regarding their condition, which can lead to extended and more in-depth conversations with their caregiver.

Structured tools: Using standard questions and checklists helps ensure that all patients receive the same level of assessment. This can:

  • Reduce reliance on personal judgement
  • Support consistency across patients
  • Help caregivers make decisions under pressure


Even a short pause interrupt automatic judgement. This can help reduce the impact of implicit bias and make all the difference.

3. Listen actively and encourage patient voice

Patients are experts in their own bodies and experiences. Active listening helps build trust and improves care. Simple strategies include:

  • Let patients finish speaking without interruption
  • Ask open-ended questions, such as “Can you tell me more about how this feels?”
  • Reflect back what you have heard to confirm understanding


Patients who feel heard and valued are more likely to share important information and follow care plans.

How Organizations Can Support Bias Reduction

Individual action matters, but support from organizations is also essential. Reducing implicit bias is not only the responsibility of individual caregivers. Healthcare organizations play a fundamental role in creating environments where fair and equitable care is possible and supported.

Helpful organizational actions include:
  • Provide regular, practical training on diversity, equity and inclusion in the healthcare space. Relevant resource here: Library & Knowledge Services: Diversity, Equity and Inclusion in Healthcare
  • Use clear policies and care standards to support consistency of care. Each healthcare organization will have their own policies and procedures to follow, it is important to approach your management if you require further clarity or have questions.
  • Encourage open discussion and learning without blame or guilt
  • Offer safe ways to report concerns or experiences of bias

When systems are designed to support equity, caregivers are better able to deliver consistent and patient-centred care.

A small shift can make a big difference

Consider this scenario7: Two women arrived at the same emergency department within minutes of each other, both with chest injuries. Despite having similar needs, their experiences were very different.

In one case, the physician spoke to the patient warmly, used her first name and ensured her pain was managed quickly. A social worker was also involved to provide updates about the patient’s injured child.

The second patient, however, received far less attention. While she lay in pain, the care team focused on admission logistics instead of the immediate medical need. Later, the physician reflected that the team’s tone and behaviour toward her were noticeably less compassionate.

The physician reflected on whether unconscious bias related to the patient’s identity, including being a transgender woman, may have influenced the interaction and care provided. This example shows how implicit bias can affect behaviour and decisions, which often happens without conscious intent.

The above scenario has been paraphrased based on the experience of a real frontline worker, please see the 7 reference for further information.

Key takeaways

Addressing implicit bias is an ongoing process. It is normal to make mistakes, especially in demanding healthcare environments. What matters most is being willing to reflect, learn and improve.

By taking small, intentional steps, such as those mentioned in this article, caregivers can reduce the impact of bias and support respectful care.

A more equitable healthcare system starts with awareness. It grows through everyday actions and commitment.

Resources
References
  1. College of Physicians and Surgeons of Ontario. (2020) Implicit bias in health care.
  2. Government of Canada. (2026). Actions to address anti-Indigenous racism in health systems. Indigenous Services Canada. 
  3. Adegoke K and Adegoke A. (2025) Systemic racism in Canadian healthcare: The impact on physicians and patient outcomes.
  4. Statistics Canada. (2025). Actions to address anti‑Indigenous racism in health systems. Government of Canada.
  5. Phelan, S. M., Burgess, D. J., Yeazel, M. W., Hellerstedt, W. L., Griffin, J. M., & van Ryn, M. (2015). Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obesity Reviews 
  6. Medical News Today. (2023). Biases in healthcare: Types, examples, and how to overcome them. 
  7. College of Physicians and Surgeons of Ontario. (2020). Scenario paraphrased from example in: Implicit bias in health care. Dialogue.