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Impact of Race on the Professional Lives of Physicians of African Descent
- Marcella Nunez-Smith, MD, MHS;
- Leslie A. Curry, PhD, MPH;
- JudyAnn Bigby, MD;
- David Berg, PhD;
- Harlan M. Krumholz, MD, SM; and
- Elizabeth H. Bradley, PhD
- From Yale University School of Medicine and Yale University School of Epidemiology and Public Health, New Haven, Connecticut; University of Connecticut School of Medicine, Farmington, Connecticut; and Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts.
Abstract
Background: Increasing the racial and ethnic diversity of the physician workforce is a national priority. However, insight into the professional experiences of minority physicians is limited. This knowledge is fundamental to developing effective strategies to recruit, retain, and support a diverse physician workforce.
Objective: To characterize how physicians of African descent experience race in the workplace.
Design: Qualitative study based on in-person and in-depth racially concordant interviews using a standard discussion guide.
Setting: The 6 New England states in the United States.
Participants: 25 practicing physicians of African descent representing a diverse range of primary practice settings, specialties, and ages.
Measurements: Professional experiences of physicians of African descent.
Results: 1) Awareness of race permeates the experience of physicians of African descent in the health care workplace; 2) race-related experiences shape interpersonal interactions and define the institutional climate; 3) responses to perceived racism at work vary along a spectrum from minimization to confrontation; 4) the health care workplace is often silent on issues of race; and 5) collective race-related experiences can result in “racial fatigue,” with personal and professional consequences for physicians.
Limitations: The study was restricted to New England and may not reflect the experiences of physicians in other geographic regions. The findings are meant to be hypothesis-generating and require additional follow-up studies.
Conclusions: The issue of race remains a pervasive influence in the work lives of physicians of African descent. Without sufficient attention to the specific ways in which race shapes physicians’ work experiences, health care organizations are unlikely to create environments that successfully foster and sustain a diverse physician workforce.
Article and Author Information
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Grant Support: In part by the Robert Wood Johnson Clinical Scholars Program and by the Patrick and Catherine Weldon Donaghue Medical Research Foundation through the Donaghue Investigator Award (02-102).
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Potential Financial Conflicts of Interest: None disclosed.
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Requests for Single Reprints: Marcella Nunez-Smith, MD, MHS, Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, IE-61, PO Box 208088, New Haven, CT 06520; e-mail, marcella.nunez-smith{at}yale.edu.
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Current Author Addresses: Dr. Nunez-Smith: Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, IE-61, PO Box 208088, New Haven, CT 06520.
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Dr. Curry: Division of Geriatrics, Department of Community Medicine and Health Care, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030.
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Dr. Bigby: Brigham and Women’s Hospital, 1620 Tremont Street, Boston, MA 02120.
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Dr. Berg: Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510.
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Dr. Krumholz: Yale University, 333 Cedar Street, Room I-456 SHM, PO Box 208088, New Haven, CT 06520.
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Dr. Bradley: Yale University School of Medicine, Department of Epidemiology and Public Health, 60 College Street, PO Box 208034, New Haven, CT 06520.
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Author Contributions: Conception and design: M. Nunez-Smith, L.A. Curry, H.M. Krumholz, E.H. Bradley.
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Analysis and interpretation of the data: M. Nunez-Smith, L.A. Curry, D. Berg, H.M. Krumholz, E.H. Bradley.
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Drafting of the article: M. Nunez-Smith, L.A. Curry, J.A. Bigby, E.H. Bradley.
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Critical revision of the article for important intellectual content: M. Nunez-Smith, L.A. Curry, J.A. Bigby, D. Berg, H.M. Krumholz, E.H. Bradley.
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Final approval of the article: M. Nunez-Smith, J.A. Bigby, H.M. Krumholz, L.A. Curry, E.H. Bradley.
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Provision of study materials or patients: M. Nunez-Smith.
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Obtaining of funding: M. Nunez-Smith.
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Collection and assembly of data: M. Nunez-Smith.
