From the New York Times news section:
For Doctors of Color, Microaggressions Are All Too Familiar
By Emma Goldberg
Aug. 11, 2020, 2:30 a.m. ET
When Dr. Onyeka Otugo was doing her training in emergency medicine, in Cleveland and Chicago, she was often mistaken for a janitor or food services worker even after introducing herself as a doctor. She realized early on that her white male counterparts were not experiencing similar mix-ups.
… After years of training in predominantly white emergency departments, Dr. Otugo has experienced many such microaggressions. The term, coined in the 1970s by Dr. Chester Pierce, a psychiatrist, refers to “subtle, stunning, often automatic, and nonverbal exchanges which are ‘put downs’” of Black people and members of other minority groups; “micro” refers to their routine frequency, not the scale of their impact.
Dr. Otugo said the encounters sometimes made her wonder whether she was a qualified and competent medical practitioner, because others did not see her that way.
Other Black women doctors, across specialties, said that such experiences were all too common. Dr. Kimberly Manning, an internal medicine doctor at Grady Memorial Hospital in Atlanta, recalled countless microaggressions in clinical settings. “People might not realize you’re offended, but it’s like death by a thousand paper cuts,” Dr. Manning said. “It can cause you to shrink.”
As I’ve been mentioning, America’s highest priority has become boosting the self-esteem of blacks, even thought studies suggest that blacks average higher self-esteem than anybody else.
The field of medicine has long skewed white and male.
Assuming you count Asian women as white men.
If only white males had not had the impertinence to invent scientific medicine in Europe in the later 19th Century. Think how much better the self-esteem of black women would be.
Only 5 percent of the American physician work force is African-American, and roughly 2 percent are Black women. Emergency medicine is even more predominantly white, with just 3 percent of physicians identifying as Black. The pipeline is also part of the problem; at American medical schools, just 7 percent of the student population is now Black.
But for Black female physicians, making it into the field is only the first of many challenges. More than a dozen Black women interviewed said that they frequently heard comments from colleagues and patients questioning their credibility and undermining their authority while on the job. These experiences damaged their sense of confidence and sometimes hampered teamwork, they said, creating tensions that cost precious time during emergency procedures.
Some physicians said they found the microaggressions particularly frustrating knowing that, as Black doctors, they brought an invaluable perspective to the care they offer.
Science Proves that they bring an invaluable perspective to the care they offer.
A 2018 study showed that Black patients had improved outcomes when seen by Black doctors, and were more likely to agree to preventive care measures like diabetes screenings and cholesterol tests.
In May, four female physicians of color published a paper in Annals of Emergency Medicine on microaggressions. The authors, Dr. Melanie Molina, Dr. Adaira Landry, Dr. Anita Chary and Dr. Sherri-Ann Burnett-Bowie, said they hoped that, by shining a spotlight on the problem, they might reduce the sense of isolation that Black female physicians experience and compel their white colleagues to take specific steps toward eliminating conscious and unconscious bias.
Discussions about lack of diversity in medicine resurfaced in early August, when the Journal of the American Heart Association retracted a paper that argued against affirmative action initiatives in the field and said that Black and Hispanic trainees were less qualified than their white and Asian counterparts.
The Asian-American doctor who wrote it got demoted and his paper retracted, but you can still read it online, just with “Retracted Article” stamped on every Page:
Dr. Phindile Chowa, 33, an assistant professor of emergency medicine at Emory University, was in her second year of an emergency-medicine residency when an attending in her department mistook her for an electrocardiogram technician, even though she had previously worked with him on rotations. She approached him to give a report on her patients, and he wordlessly put out his hand, expecting her to hand over an electrocardiogram scan.
“He never apologized,” Dr. Chowa said. “He did not think he did a single thing wrong that day. I was the only Black resident in my class. How could he not know who I am?”
The derogatory encounters continued from there. Colleagues have referred to her as “sweetie” or “honey.” She recalled one patient who asked repeatedly who she was over the course of a hospital visit, while quickly learning the name of her white male attending physician.
Confused patients are racist and deserve to die. There should be no mercy for patients who commit microaggressions: just wheel them out onto the sidewalk and leave them there.
When she was first admitted to her residency, at Harvard, a medical school classmate suggested that she had had an “edge” in the selection process because of her race.
Well, she did, a big one, but you aren’t supposed to mention that.
Such comments can create an environment of fear for Black women. Dr. Otugo recalled overhearing her Black female colleagues in Chicago discuss how they were going to style their hair for their clerkships. Many of them worried that if they wore their hair naturally, instead of straightening it or even changing it to lighter colors, their grades and performance evaluations from white physicians might suffer.
Dr. Sheryl Heron, a Black professor of emergency medicine at Emory University School of Medicine, who has worked in the field for more than two decades, said microaggressions can exact a long-lasting toll. “After the twelve-thousandth time, it starts to impede your ability to be successful,” she said. “You start to go into scenarios about your self-worth. It’s a head trip.”
This comes on top of the stresses that are already pervasive in emergency departments. A 2018 survey of more than 1,500 early-career doctors in emergency medicine found that 76 percent were experiencing symptoms of burnout.
I’m not an expert on emergency care, but my impression from watching MASH is that it helps to have a rather callous personality that is not easily bruised.