2020 NASS Annual Meeting: Question Your Biases, Says NASS President

William J. Sullivan, MD, kicked off the 2020 NASS annual meeting by exhorting his colleagues to challenge their preconceived judgements.

“If 2020 were a yearly bonus, it would be a Jelly of the Month certificate.”

So said William J. Sullivan, MD, North American Spine Society (NASS) president, channeling the classic Chevy Chase film National Lampoon’s Christmas Vacation to open NASS’s virtual annual meeting.

NASS introNASS President William J. Sullivan, MD, kicks off the first virtual annual meeting on Oct. 6, 2020.

The 35th NASS annual meeting kicked off on October 6, 2020. After a welcome from incoming NASS president and SpineUniverse editorial board member Eeric Truumees, MD, Dr. Sullivan provided a look at some of the societies priorities and efforts around combating bias and increasing diversity.

Most of Dr. Sullivan’s portion of the introductory address was aimed at defining and describing bias. Dr. Sullivan pointed out that bias is neither inherently good nor inherently bad. It’s “an automatic response in judgment that provides shortcut for future actions,” he said.

He pointed out that physicians use bias all the time. “In medicine, we’re taught to hone skills of bias, such as pattern recognition,” said Dr. Sullivan. But, even in a clinical setting, bias can be dangerous when doctors slip into diagnosis bias and confirmation bias, which can lead to selective inattention and inattentional blindness.

Dr. Sullivan cited a 2013 study published in Psychological Science entitled “The invisible gorilla strikes again: Sustained inattentional blindness in expert observers.” In it, 24 radiologists were asked to look for lung nodules on a CT scan. More than four out of five observers failed to register a photo of a gorilla (48 times larger than a lung nodule) hidden in the scan.

He outlined a number of steps clinicians can take to reduce their unconscious biases. “The first thing is you need to recognize and accept that you have bias. We all do,” he said. He also recommended:

  • Developing a capacity to “use a flashlight on yourself.”
  • Ask for feedback.
  • Engage with others, particularly those who are of a different specialty, training, socioeconomic background, etc. from you.
  • Explore awkwardness and discomfort. Have tough conversations about racial bias.
  • Practice constructive uncertainty. “When you’re considered the smartest person in the room or the place where the buck stops, it can be hard to think you might be incorrect,” said Dr. Sullivan.

Dr. Sullivan also discussed the differences between equality and equity. Equality, he said, is where everyone gets the same resources. Equity, on the other hand, is where everyone gets the same opportunities. “When thinking about equality, you need to consider other barriers,” he said.

Finally, Dr. Sullivan mentioned that in 1985, the year NASS was founded, the Heckler report—the first comprehensive documentation of racial disparities in healthcare—came out. “It put a spotlight on pervasive inequalities in health,” he said. Although there has been some progress made, it hasn’t been enough he said, citing diabetes statistics within Black communities in the United States.

“In many ways, we’re going backwards,” said Dr. Sullivan. “As NASS continues its work, I hope we can address bias.”

Updated on: 10/06/20
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