Racial and ethnic discrimination in the workplace: Career trajectories of practicing physicians

BACKGROUND: Increasing racial and ethnic diversity in the physician workforce is a national priority. However, prior studies suggest that the majority of racial and ethnic physicians experience discrimination at work. Little is known about the relationship between racial and ethnic discrimination and the career paths of practicing physicians. This information is needed to determine the full impact of racial and ethnic discrimination on the physician workforce.

METHODS: Using the AMA Masterfile, we identified and surveyed a random sample (n= 529 respondents, 53% response rate) of practicing physicians in the U.S. and randomly oversampled physicians of African descent using the membership roster of the National Medical Association. The majority of respondents identified their race as white (62%). Black (17%), Asian (14%), and Hispanic/Latino (a) (6%) physicians were overrepresented in proportion to their prevalence in the US physician population. The gender distribution of the respondents reflected the current physician workforce distribution, and 70% of respondents were male. We evaluated the personal and professional physician characteristics associated with racial and ethnic discrimination. Using bivariate and logistic regression analyses, we examined the association between reported experiences of racial and ethnic discrimination and unplanned job turnover. We also queried participants on a range of views and experiences on race, ethnicity, and discrimination within health care settings. Our questionnaire was developed based upon our published qualitative work in this area.

RESULTS Many physicians reported having experienced racial and ethnic discrimination at work (69% of physicians of African descent, 45% of Asian physicians, 24% of Hispanic or Latino (a) physicians, 56% of physicians of other race and 9% of white physicians). Several physicians reported having left at least one job because of discrimination (30% of physicians of African descent, 24% of Asian physicians, 20% of Hispanic or Latino (a) physicians, 20% of physicians of other race and 10% of white physicians). Compared with physicians who had never experienced racial and ethnic discrimination at work, physicians who reported having experienced such discrimination were significantly more likely (OR: 2.2, 95% CI: 1.2, 4.3) to have high unplanned job turnover. Race and ethnicity were not significantly associated with high unplanned job turnover.

CONCLUSIONS: Our findings indicate that experiencing racial and ethnic discrimination at work is strongly linked to high unplanned job turnover across a diverse sample of practicing physicians in the United States, suggesting that identifying and mitigating discriminatory experiences is essential to support physician workforce diversity.