Abstract
IntroductionDespite the increasing diversity of individuals entering medicine, physicians from racial and sexual minority groups continue to experience bias and discrimination in the workplace. The objective of this study was to determine the current experiences and perceptions of discrimination on the basis of race and sexual orientation among academic emergency medicine (EM) faculty.MethodsWe conducted a cross-sectional survey of a convenience sample of EM faculty across six programs. Survey items included the Overt Gender Discrimination at Work (OGDW) Scale adapted for race and sexual orientation, and the frequency and source of experienced and observed discrimination. Group comparisons were made using t-tests or chi-square analyses, and relationships between race or sexual orientation, and we evaluated physicians’ experiences using correlation analyses.ResultsA total of 141 out of 352 (40.1%) subjects completed at least a portion of the survey. Non-White physicians reported higher mean racial OGDW scores than their White counterparts (13.4 vs 8.6; 95% confidence interval (CI) for difference, −7.7 – −2.9). Non-White EM faculty were also more likely to report having experienced discriminatory treatment based on race than were White EM faculty (48.0% vs 12.6%; CI for difference, 16.6% – 54.2%), although both groups were equally likely to report having observed race-based discrimination of another physician. EM faculty who identified as sexual minorities reported higher mean sexual minority OGDW scores than their heterosexual counterparts (11.1 vs 7.1; 95% CI for difference, −7.3 – −0.6). There were no significant differences between sexual minority and heterosexual faculty in their reports of experiencing or observing discrimination based on sexual orientation.ConclusionEM faculty from racial and sexual minority groups perceived more discrimination based on race or sexual orientation in their workplace than their majority counterparts. EM faculty regardless of race or sexual orientation were similar in their observations of discriminatory treatment of another physician based on race or sexual orientation.
Highlights
Despite the increasing diversity of individuals entering medicine, physicians from racial and sexual minority groups continue to experience bias and discrimination in the workplace
emergency medicine (EM) faculty from racial and sexual minority groups perceived more discrimination based on race or sexual orientation in their workplace than their majority counterparts
EM faculty regardless of race or sexual orientation were similar in their observations of discriminatory treatment of another physician based on race or sexual orientation. [West J Emerg Med. 2020;21(5)1160-1169.]
Summary
Despite the increasing diversity of individuals entering medicine, physicians from racial and sexual minority groups continue to experience bias and discrimination in the workplace. States medical schools in 2019 self-reported as non-White.[1] Despite the increasing diversity of individuals entering medicine, physicians from racial minority groups continue to experience racial bias and discrimination in the workplace, including disparities in career satisfaction, job turnover, federal research grants, and academic promotion.[2,3,4,5,6,7] Many studies have detailed racial discrimination of minority medical students and physicians.[2,6,8,9] There is currently little data describing racial discrimination in academic emergency medicine (EM).[10,11,12] A better understanding of the current workplace environment with regard to racial discrimination will aid efforts to promote equity, inclusion, and diversity within the emergency physician workforce. Many physicians who identify as lesbian, gay, bisexual, or transgender (LGBT) report workplace harassment, social ostracization, and discriminatory treatment.[13,14] A significant proportion of LGBT physicians, trainees, and medical students cited concerns of discrimination and harassment for their need to conceal their sexual or gender identities.[15,16,17,18] LGBT providers’ discomfort with this disclosure is one contributor to their higher levels of distress, burnout, and depression compared to their heterosexual colleagues.[14,15,16,19] Few studies have examined the experiences with workplace discrimination among physicians who identify as sexual minorities.[13,14,20] Current data on this understudied provider population will fill an important knowledge gap and inform the aforementioned diversity efforts of both EM and healthcare in general
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