As a Black Woman and Physician, It’s Time to End Microaggressions in Medicine

Just 5 percent of U.S. physicians are Black. Medical educators, administrators and hospital leadership can change this by standing up to microaggressions and racism in the workplace.

(The Good Brigade / Getty Images)

Verbally aggressive. Intimidating. Angry. These thinly veiled racist dog whistles aimed against Black physicians like me are microaggressions that negatively impact our mental health and work satisfaction. We operate in a world where a Black female physician is “verbally aggressive” for the same behavior that labels her white male colleague as “assertive.”

These attacks on our professionalism in the workplace result in us being disproportionately dismissed or disciplined within the medical field. In many states, Black women’s natural hair is considered “unprofessional,” discouraged within the workplace. As a result, organizations such as the CROWN Act, are working to ensure protection against racial discrimination based on hairstyles in professional settings and schools.

Studies show that anger, a commonly expressed workplace emotion, is more likely to be attributed to a Black woman’s personality than an inciting event when compared to her counterparts. Similar emotional adjectives are disproportionately showing up in Black students’, residents’ and physicians’ evaluations.

Anti-Black sentiments decrease the number of underrepresented minorities working in medicine, resulting in poorer outcomes for underrepresented minority patients. It is the responsibility of hospital and medical education leadership to create an equitable and anti-racist culture that fights the microaggressions disproportionately harming Black physicians of all gender identities. Here’s how.

First, stakeholders in the medical community need to deeply consider which voices are being elevated in medical institutions. Does their website tout “diversity, equity and inclusion” while valuing white fragility over the experiences of those being oppressed? Is tone-policing at play? The way in which disputes involving issues of race or other identities are handled, sends a clear message to faculty and staff about what behavior is allowed and by whom.

Medical educators and hospital leadership also hold responsibility to create quantifiable curriculum and training interventions that teach implicit bias. People need the tools to recognize and correct their biases to prevent unfair evaluation of students and residents, unpleasant encounters with colleagues or potentially dangerous encounters for patients. For example, a physician’s false assumption that Black patients have higher pain tolerances or are drug seekers leads to inadequate pain management and adverse outcomes. Quantifiable curriculum, research and policy-based interventions can set the foundation to identifying this behavior in the medical field and correcting it.

A reassessment of professional appearance and behaviors outside of white-led standards is critical for progress. Hijabis—individuals who wear hijab—are often discriminated against in the workplace or don’t have the equipment available to them to safely care for patients. Healthcare leadership can easily address these issues by regularly reviewing professionalism policies and standards, creating inclusive committees to review the standards, and ordering inclusive work environment equipment. This is one example of why curriculum and vision statement development must happen from a lens of diversity, equity and inclusion.

The practice of medicine undoubtedly requires discipline, sacrifice and professionalism. But physicians are also people who bring implicit biases and prejudicial practices to the field, despite their best efforts. These implicit biases often result in microaggressions and covert racism that negatively impact how underrepresented minorities are perceived and treated, both in the workplace and as patients.

If Black providers are more commonly described as “aggressive,” “intimidating” or “unprofessional,” then it is up to leadership to discover why, instead of erroneously concluding that the observation is fact. It is not fact, it is perception.

Inequitable and inaccurate behavior assessments of Black physicians create a toxic work environment, workplace dissatisfaction, and unfair disciplinary actions and dismissals. In 2019, just 5 percent of U.S. physicians were Black. If these numbers stay stagnant or dwindle, workforce diversity, Black physicians and patients will suffer. Ultimately, there will be even fewer Black women in medicine like myself. Medical educators, administrators and hospital leadership have the power to change this—and it’s time to utilize that power in the right way.

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Katrina Gipson is an assistant professor of emergency medicine at Emory University School of Medicine. She is the founding program director of the Health Policy Fellowship at Emory and a public voices fellow of The OpEd Project and AcademyHealth.