During one of my shifts in the ED, I sat beside an attending–black, woman–one of the very few black women in medicine that I have had a chance to encounter in my line of work. She exudes confidence and knowledge. She mentioned that she always wears her white coat despite the fact that it gets dirty very fast in a busy emergency department.
I listened to her talk to a scribe who was attempting go to med school about her experiences in medicine. She related that in her first job she was pushed out and targeted collectively and unfairly. In her second job, she had a repeat experience, so she learned how to defend herself, and was able to negotiate a better severance pay. Several jobs later, she finally found her niche or at least became well versed in navigating through the bias.
I was very interested in her experiences because I am a small woman of color (my last name sounds Latinx, but I am Asian), who also practice in the same line of work.
Joint Commission defines implicit bias as the attitudes or stereotypes that affect our actions voluntarily or involuntarily.
My experiences so far as an advance practitioner has been similar–patients, nurses, colleagues alike pose challenges and question my knowledge unfairly and excessively, whereas, a male/female caucasian colleague can accomplish similar tasks without road blocks, and find easy acceptance. The worse challenges come from other people of color who often prefer, and sometimes requests, the male caucasian provider, only to be told the similar instructions that I have given.
According to the the Association of American Medical Colleges, only 5% of all active physicians are Black vs 13% of the US population, and worse for Hispanic or Latinx 2.4% of active physicians are women, a total of 5.8% of doctors are Hispanic, when they are 18% of the overall US population (AAMC.org). It’s easy to assume that Healthcare is innovative, but actually it is slow to adapt to new ideas. It is reflective but oftentimes lack the stamina and will to change,– thus, many researchers and clinicians will say, “it takes 17 years to move evidence into practice”.
I talked to my father the other day, to discuss my experiences in healthcare, including the challenges of implicit bias. I wonder why do I try? He said, if God gave you the energy, the brains and the desire to change the landscape of healthcare, and move the needle against the status quo of systemic racism (overt or hidden), then you must. Emergency medicine is exhausting, I wonder where do I find the energy and desire to keep going?
Reflections on Health and Well-being 