Kelly Serafini, PhD | Caitlin Coyer, MS | Joedrecka Brown Speights, MD | Dennis Donovan, PhD | Jessica Guh, MD | Judy Washington, MD | Carla Ainsworth, MD, MPH
The purpose of this study was to examine the impact of racism experienced by physicians of color in the workplace.
BACKGROUND AND OBJECTIVES: The purpose of this study was to examine the impact of racism experienced by physicians of color in the workplace. METHODS: We utilized a mixed-methods, cross-sectional, survey design. Seventy-one participants provided qualitative responses describing instances of racism from patients, colleagues, and their institutions. These responses were then coded in order to identify key domains and categories. Participants also completed quantitative measures of their professional quality of life and the incidence of microaggressions experienced while at work. RESULTS: We found that physicians of color were routinely exposed to instances of racism and discrimination while at work. Twenty-three percent of participants reported that a patient had directly refused their care specifically due to their race. Microaggressions experienced at work and symptoms of secondary traumatic stress were significantly correlated. The qualitative data revealed that a majority of participants experienced significant racism from their patients, colleagues, and institutions. Their ideas for improving diversity and inclusion in the workplace included providing spaces to openly discuss diversity work, constructing institutional policies that promote diversity, and creating intentional hiring practices that emphasize a more diverse workforce. CONCLUSIONS: Physicians of color are likely to experience significant racism while providing health care in their workplace settings, and they are likely to feel unsupported by their institutions when these experiences occur. Institutions seeking a more equitable workplace environment should intentionally include diversity and inclusion as part of their effort.
In 2003, the Institute of Medicine released their comprehensive report on racism in medicine, which documented extensive racial disparities across a multitude of health outcomes.1 Since then, there has been accumulating evidence that racism, discrimination, implicit bias, and structural inequalities have substantially impacted health care delivery and outcomes.2-4 Although there is a growing body of evidence documenting the harmful effects of racism on patient care, comparatively much less is known about how racism and discrimination affect physicians of color.5,6 The long-term impact of such occupational stressors such as racism and discrimination remains unknown, especially as it relates to job satisfaction and burnout.A recent commentary on this issue concluded that it is critical that researchers begin to study how discrimination affects physicians of color.7 Thus, the primary purpose of this study was to survey physicians of color about their experiences regarding institutional racism, racism from colleagues, and racism from patients using a qualitative approach. A secondary purpose of this study was to examine the impact of workplace microaggressions on professional quality of life. Using a quantitative approach, we hypothesized that a greater incidence of microaggressions experienced at work would be correlated with higher levels of burnout indicators.