In this MD Newsline exclusive interview with psychiatrist Dr. Edward Hallowell, we discuss how to address ADHD disparities and psychiatrist implicit bias.
How would you recommend psychiatrists rectify disparities in ADHD diagnosis and treatment?
Dr. Edward Hallowell:
“We need to educate ourselves. And that’s not always easy because we tend to think we know what we need to know, and we don’t know what we don’t know. We need to listen to our colleagues, listen to our patients above all, and we need to be ready to say, ‘I didn’t know that. Maybe this patient is telling me something, and I’m dismissing it as a fad or not worth knowing when in reality, I’m missing something important.’
If you can do that—you’re home free. You’ll get advice from colleagues that know more about ADHD than you do. Even though you may think you know everything—you don’t. I’m an expert in the field, and I don’t know everything. None of us knows everything.
So, if we start from a position of humility and curiosity, we will better serve our profession and our patients with ADHD.”
How can psychiatrists address implicit bias in their practice?
Dr. Edward Hallowell:
“We can address implicit bias in psychiatry by addressing implicit bias in our everyday lives. We need to try to open our minds and recognize our own biases and prejudices. And that’s hard to do because you don’t volunteer for these things. You don’t say, ‘Yeah, I really want to be a bigot.’ Or, ‘I really want to be biased.’ Or, ‘I really want to be ignorant.’ We all acquire implicit bias from our lived experiences, and almost by definition, we’re not aware of it.
So, we need to listen to feedback from others. We need to read journals and books. And we need to listen to our patients. Many patients, particularly women, come to me and say, ‘I just couldn’t find a doctor who would take me seriously. I told my doctor I think I have ADD, and he said I didn’t have it because I was doing too well in life.’
So, listen to your patients. Let them bring you past your biases. Then, you’ll become a much better doctor because you’ll serve them much more effectively. As physicians, we espouse the value of listening to our patients, but we often don’t live it out.
In short, to get past your biases, get educated, and recognize your blind spots by letting your patients show them to you.”
Responses have been condensed and lightly edited.