Listening to our peers so we can listen to our patients: a survey of racism experienced by gynecologic oncologists

Abstract

<h3>Objectives:</h3> To examine the role of race and ethnicity in the professional experiences and development of physicians in gynecologic oncology. <h3>Methods:</h3> We conducted a survey of US physician members of the Society of Gynecologic Oncology. Participants were queried about demographics, perceived role of their self-identified race and ethnicity on daily professional activities, development, and experiences with discrimination. Responses were collected on a continuous scale from 0-100, where 0 is strongly disagree and 100 is strongly agree. For the analysis, we dichotomized the continuous response to a binary outcome where the collected response > 50 is 1, and 0 otherwise. All survey responses and demographic and outcome questions were analyzed descriptively using frequency (percent). The outcome questions were also summarized by whether participant self-identified as White/non-White, and chi-square and Fisher's exact tests were performed to test independence. <h3>Results:</h3> The survey was sent to 1455 members; 21% (309) responded. A total of 80 respondents were excluded because none of the outcome questions were answered. Of the 229 remaining respondents, 69% (159) were female. A total of 78 percent (178) identified as White/Caucasian, 11% (26) as Black, 1% (2) as American Indian or Alaska Native, 10% (22) as Asian, and 5% (11) as Hispanic/Latino. Median age was 42 years (range, 30-82). A total of 14 (32) were trainees. Demographics can be found in Table 1. Non-white respondents (NW) were more likely to report negative experiences in their medical training and/or professional career (p<0.01) and experiences with discrimination at work (p<0.01) as a result of their racial/ethnic background. NW were also more likely to report their race/ethnicity affected interactions with their peers or trainees, staff, and patients (p=0.004). When asked about race/ethnicity contributing to inconsistent professional expectations, there was no reported difference between White and NW participants (p=0.2). However, NW were more likely to suspect their racial/ethnic background negatively impacted their ability to be promoted or considered for job opportunities (p<0.001) and felt their actions/outcomes were unfairly critiqued because of their race/ethnicity (p<0.001). More NW participants reported feeling like an outsider in social interactions at work (p=0.004) and often felt they could not relate to their colleagues (p=0.002). However, there was no difference among respondents regarding reported social and professional support within and outside the workplace (p=0.9 and p=0.5, respectively) or with difficulty finding mentorship (p=0.6). A total of 85% of respondents, regardless of race, felt there is a need for increased diversity amongst gynecologic oncologists, and 66% indicated they were comfortable talking about issues of race; 65% believed race often negatively influences the care minority patients receive; 71% of felt compelled to protect minority patients; and 68% felt compelled to protect minority trainees. There was no statistically significant difference between White and NW participants for any of these questions. <h3>Conclusions:</h3> Gynecologic oncologists appear to have different professional experiences associated with their race/ethnicity. NW respondents more commonly report negative and discriminatory experiences. However, in this national survey, gynecologic oncologists across all race/ethnicities recognize the inequalities and disparities that exist and appear to be motivated to address them.