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"She doesn't exercise."
Did you ask her if she exercises?
"No, but she doesn't look like she exercises."
Sigh.
Did you ask her if she exercises?
"No, but she doesn't look like she exercises."
Sigh.
This is not how it works. This is not how any of this works.
You cannot make assumptions about the patient in front of you. You will be wrong most of the time, but our self-preserving egos will hold on to the few times we are right in order to continue our practices of bias.
What do we do about it? Biases don't go away overnight. I have a couple recommendations. 
In no particular order
1) Consider the evidence for your bias. Are there papers that discuss your assumption or recommendation? When was the last time you looked? Take a peek at the evidence and see what's there.
1) Consider the evidence for your bias. Are there papers that discuss your assumption or recommendation? When was the last time you looked? Take a peek at the evidence and see what's there.
2) Try to take inventory of *when* you make a certain assumption. Do you find yourself having an emotional or judgmental response to people of a certain age? Weight? Race? Body habitus? Occupation? Sometimes just tuning into when you're having those responses can be illuminating.
3) If you can, keep track of these response episodes. Can be as simple as a tally mark on a piece of paper or a note in your phone. How many times a day do you find yourself sighing in frustration at a patient, suppressing an eye roll, or something else?
We know, based on mountains of evidence, that biased care leads to bad outcomes. That starts, almost always, in the history. If you get a biased history, you'll make a biased assessment and enact a biased plan.
We can do better than that.
We can do better than that.
