LAUSR

E qual care for all patients regardless of race, sex, or socioeconomic status has been a central goal of health care for many years. At our institution, the Massachusetts General Hospital (MGH), this goal is explicitly stated in our credo: ‘‘.. . issues of equity and justice are not separate but rather intertwined with patient care, education, research and community health. Targeting inequality enhances the quality of care for all. We believe in treating our patients and each other with the dignity that every human being deserves.’’ Numerous organizations, including the Joint Commission, the National Academy of Medicine, and the American College of Surgeons, have also highlighted the need to combat inequities and biases that exist in health care. Furthermore, the current divisive environment in America has highlighted the pervasiveness of harmful biases and prejudices, providing significant motivation to undercover and specifically address biases that can affect our delivery of health care. In response to this calling, a group of faculty and residents in the MGH Department of Surgery (DoS) founded the Community Health Collaborative in 2016, with the objective to evaluate and improve the care we provide for all our patients, not only when they are in the hospital, but throughout their daily lives. This group developed 3 primary tenets: (1) to improve the DoS’ outreach efforts within our surrounding community, (2) to increase the level of awareness within our department regarding social determinants of health and health care disparities, and (3) to provide an academic foundation to guide the aforementioned efforts. With the support and encouragement of departmental leadership, the Community Health Collaborative first embarked on efforts to understand our own levels of bias within the MGH DoS, to guide future interventions targeted at improving our clinical culture and patient care. In looking to shed a light on our own biases, we sought to better understand the extent and complexity of both our explicit and implicit biases. Explicit biases are openly acknowledged and accepted, whereas implicit biases are unconscious attitudes or stereotypes that affect our understanding, actions, and decisions, and often differ from our explicit views. Because individuals are typically unaware of their implicit biases, their impact on behavior is particularly insidious. Evidence-to-date has demonstrated the negative impact of implicit bias in the workplace, the judicial system and law enforcement, and most relevant to our profession, health care. Although it is difficult