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“This happens all the time”: a Qualitative Study of General Internists’ Experiences with Discriminatory Patients

BACKGROUND: Workplace discrimination negatively affects physicians of color personally and professionally. Although the occurrence of discrimination from patients has been visible in social media, popular press, and personal essays, scant research exists on patients as a source of discrimination dir...

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Autores principales: Filut, Amarette, Alexander, Lacey, Ray, Alexis, Pecanac, Kristen, Carnes, Molly
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8007052/
https://www.ncbi.nlm.nih.gov/pubmed/33782894
http://dx.doi.org/10.1007/s11606-021-06696-7
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author Filut, Amarette
Alexander, Lacey
Ray, Alexis
Pecanac, Kristen
Carnes, Molly
author_facet Filut, Amarette
Alexander, Lacey
Ray, Alexis
Pecanac, Kristen
Carnes, Molly
author_sort Filut, Amarette
collection PubMed
description BACKGROUND: Workplace discrimination negatively affects physicians of color personally and professionally. Although the occurrence of discrimination from patients has been visible in social media, popular press, and personal essays, scant research exists on patients as a source of discrimination directed at physicians of color. OBJECTIVE: To explore practicing general internists’ experiences observing or interacting with patients exhibiting discriminatory behavior directed at physicians of color. DESIGN: A qualitative study with in-depth, semi-structured, one-on-one telephone interviews conducted and recorded between May and September 2019. PARTICIPANTS: A purposive sample of 24 general internists practicing at 12 academic health centers in the USA: 14 self-identified as White and 10 as a physician of color, which included Asian, Black, Native American, and self-identified other race. APPROACH: Four coders analyzed the transcribed and verified interview text; thematic analysis was used to inductively identify cohesive themes and subthemes. KEY RESULTS: Analyses revealed four major themes: (1) assumption that a legitimate doctor is White, male, and able-bodied; (2) legacy of the Black experience; (3) working through the struggle of discrimination; and (4) ethical dilemma of providing care to discriminatory patients. In addition to discrimination from patients based on a physician’s race or ethnicity, participants described experiencing or observing discrimination based on a physician’s gender and disability status. Participants generally expressed a need for greater support from colleagues and more guidance from institutional policies. CONCLUSIONS: General internists practicing in academic settings reported observing or experiencing discrimination from patients based on the physician’s race, ethnicity, gender (or their intersection), and disability status and the ethical dilemma of providing care to such patients. These results contribute to growing evidence of the need for institutions to better support an increasingly diverse physician workforce with policies and specific guidance to help physicians respond to discrimination from patients while still providing quality care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11606-021-06696-7.
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spelling pubmed-80070522021-03-30 “This happens all the time”: a Qualitative Study of General Internists’ Experiences with Discriminatory Patients Filut, Amarette Alexander, Lacey Ray, Alexis Pecanac, Kristen Carnes, Molly J Gen Intern Med Original Research BACKGROUND: Workplace discrimination negatively affects physicians of color personally and professionally. Although the occurrence of discrimination from patients has been visible in social media, popular press, and personal essays, scant research exists on patients as a source of discrimination directed at physicians of color. OBJECTIVE: To explore practicing general internists’ experiences observing or interacting with patients exhibiting discriminatory behavior directed at physicians of color. DESIGN: A qualitative study with in-depth, semi-structured, one-on-one telephone interviews conducted and recorded between May and September 2019. PARTICIPANTS: A purposive sample of 24 general internists practicing at 12 academic health centers in the USA: 14 self-identified as White and 10 as a physician of color, which included Asian, Black, Native American, and self-identified other race. APPROACH: Four coders analyzed the transcribed and verified interview text; thematic analysis was used to inductively identify cohesive themes and subthemes. KEY RESULTS: Analyses revealed four major themes: (1) assumption that a legitimate doctor is White, male, and able-bodied; (2) legacy of the Black experience; (3) working through the struggle of discrimination; and (4) ethical dilemma of providing care to discriminatory patients. In addition to discrimination from patients based on a physician’s race or ethnicity, participants described experiencing or observing discrimination based on a physician’s gender and disability status. Participants generally expressed a need for greater support from colleagues and more guidance from institutional policies. CONCLUSIONS: General internists practicing in academic settings reported observing or experiencing discrimination from patients based on the physician’s race, ethnicity, gender (or their intersection), and disability status and the ethical dilemma of providing care to such patients. These results contribute to growing evidence of the need for institutions to better support an increasingly diverse physician workforce with policies and specific guidance to help physicians respond to discrimination from patients while still providing quality care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11606-021-06696-7. Springer International Publishing 2021-03-29 2021-06 /pmc/articles/PMC8007052/ /pubmed/33782894 http://dx.doi.org/10.1007/s11606-021-06696-7 Text en © Society of General Internal Medicine 2021
spellingShingle Original Research
Filut, Amarette
Alexander, Lacey
Ray, Alexis
Pecanac, Kristen
Carnes, Molly
“This happens all the time”: a Qualitative Study of General Internists’ Experiences with Discriminatory Patients
title “This happens all the time”: a Qualitative Study of General Internists’ Experiences with Discriminatory Patients
title_full “This happens all the time”: a Qualitative Study of General Internists’ Experiences with Discriminatory Patients
title_fullStr “This happens all the time”: a Qualitative Study of General Internists’ Experiences with Discriminatory Patients
title_full_unstemmed “This happens all the time”: a Qualitative Study of General Internists’ Experiences with Discriminatory Patients
title_short “This happens all the time”: a Qualitative Study of General Internists’ Experiences with Discriminatory Patients
title_sort “this happens all the time”: a qualitative study of general internists’ experiences with discriminatory patients
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8007052/
https://www.ncbi.nlm.nih.gov/pubmed/33782894
http://dx.doi.org/10.1007/s11606-021-06696-7
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