Dr. Damon Tweedy, a psychiatrist and professor at Duke University, authored the book, Black Man in a White Coat, in which he describes a medical system that includes not only unequal treatment of patients, but of the physicians themselves…a system that can be “just as sick as its patients.”
A new publication authored by SMPH scholars Drs. Amy Filut, Madelyn Alvarez, and Molly Carnes in the Journal of the National Medical Association documents “workplace discrimination experienced by physicians of color, particularly Black physicians and women of color.” Such discriminatory experiences included not only refusal of care by patients, but discriminatory interactions with their White health provider peers, consistent with experiences documented by Dr. Tweedy.
Their systematic review of empirical studies revealed that the discrimination physicians identifying as Black, Latinx, Native American or Alaska Native, Asian, Native Hawaiian, or other Pacific Islander experience negatively affected not only their career, but also the physicians’ health as well. The authors did not find any published studies that evaluated interventions to reduce discrimination against physicians of color in the workplace. Angela Byars-Winston, Professor of Medicine and CCHE Associate Director comments,
The reality is that racism in medicine and health care has paralleled racism in society. And we know that racism doesn’t just happen passively; there are systems and mindsets that actively reinforce the many forms that racism takes from implicit and explicit biases to outright discrimination. Something needs to be done with intention to ensure a respectful and healthy workplace for physicians of color.
Recognizing the need to address workplace challenges for physicians of color, Byars-Winston joined CCHE Senior Associate Director Christine Sorkness (Professor of Pharmacy) to collaborate with SMPH leaders in creating a new program in 2019, Building Equitable Access to Mentorship (BEAM). BEAM connects trained faculty mentors with medical students from under-represented racial/ethnic groups in medicine. The primary goal is to support student talent development by building self-efficacy for degree completion and skills to navigate cultural diversity dynamics that can arise in their career progression as emerging physicians of color.
An important outcome of BEAM has been the community of practice amongst the faculty mentors themselves, most identified as physicians of color, who are finding mutual support and sharing strategies for thriving in academic medicine, including addressing bias and discrimination. Byars-Winston adds,
We have to be honest; the workplace is the people; the climate is the people. It’s easier to use generic words like “workplace” and “climate” than to call out individuals. But transforming and improving the workplace means that individuals have to change. While we are working on improving the behaviors of majority group members, we can facilitate the persistence of those individuals from underrepresented backgrounds.
Additionally, Robert N. Golden, UW-Madison’s Dean of the School of Medicine and Public Health, notes,
The article by Dr. Carnes and her colleagues shines light on a very ugly truth: physicians of color are subjected to discrimination in the workplace. This completely contradicts the fundamental values of medicine in general, and academic medicine in particular. I wish we could say that our School of Medicine and Public Health is immune from this illness….but that is not the case.
We are dedicated to evolving as a national leader in promoting a fair, equitable, and just workplace for all. We hope the entire SMPH community will embrace this challenge and participate in our commitment to Building Community.
The UW Collaborative Center for Health Equity shares the conclusions reached in the new article by Dr. Filut and her colleagues and the sentiments of Dr. Byars-Winston and Dean Golden. We recognize and support the value added of the BEAM program to advance an inclusive and excellent diverse medical workforce and appreciate the SMPH efforts towards Building Community.
Find the JAMA article here.