Beyond silence and inaction: responding to racism in the healthcare workforce

A patient's family member tells a black physician that “black people are normally not smart." The family member then mistakes N.M., another black physician, for her co-intern, and tells her she’s “really smart for a black person.” How can a physician be empowered to respond to this kind of racism in the workplace? What can her colleagues and institution do to make her feel empowered and respected and clearly communicate that such racism is not tolerated?

Bixby member Dr. Andrea Jackson, along with colleagues Drs. Sara Whetstone and Ashish Premkumar, take on this pressing topic in a commentary for Obstetrics and Gynecology. In 2015, only 6% of medical school graduates identified as black or African American and 5% as Hispanic, Latino or Latina. Physicians who experience racism are less likely to feel satisfied in their careers and welcomed in their institutions. Stories like N.M.’s show how inequality and discrimination seeps into the workplace.

The authors offer a series of next steps as a starting point for a multifaceted effort to tackle racism in the healthcare workforce:

  • Institutions must develop explicit policies that address racial discrimination, such as the Penn State Health Patient’s bill of rights, which states that requests to change providers or other staff based on race or other characteristics will not be honored.
  • Individuals should learn about their institution’s policies and their rights, and seek interpersonal support.
  • Witnesses who don’t feel equipped to deal with racist incidents need to take steps to develop those skills and be well-versed in institutional policies. If those policies don’t exist, they should demand them.
  • Educators have an obligation to create an environment that allows trainees to thrive even when acts of discrimination occur. They should respond to racist incidents in a way they respond to other adverse events—acknowledge the incident, initiate a team debriefing and identify and reinforce opportunities for professional growth.

There has been a lot of debate about racism within reproductive health care, but little has been achieved to rectify inequalities. The authors call for individuals to reconsider not only their own perspectives, but those of the entire system that continues to foster discrimination. The next generation of reproductive health educators, researchers and providers has an obligation to acknowledge and fight against the effects of racism in the lives of colleagues.