A few months ago, I blogged about the considerable evidence of gender discrimination and sexual harassment in the medical profession. Here, I turn to the persistent racial and ethnic disparities among physicians. Like gender disparities, racial and ethnic disparities in medicine manifest in multiple forms—in pay, promotions, and harassment from colleagues and patients.
A growing body of evidence suggests that black, Latino, and Asian physicians make considerably less than their white counterparts. A 2016 study published in the BMJ found in the 2010-13 period, “white male physicians had an adjusted median annual income of $253 042 . . . compared with $188 230 . . . for black male physicians.” Similarly, according to Medscape’s 2018 Physician Compensation Survey, black, Latino, and Asian physicians earn $50,000, $30,000, and $15,000 less than their white counterparts, respectively.
Studies have found similar disparities in promotions. A 2010 literature review describes a number of studies from the late 1990s and early 2000s, which show that black, Latino, and Native American physicians in academic medicine are less likely to receive promotions than their white counterparts. More recent articles in the American Journal of Public Health (2012) and in Academic Medicine (2018) report similar results, as does a recent survey of Emergency Medicine doctors.
Unsurprisingly, minority medical students and faculty members report experiencing discrimination during their careers. A 2004 survey of 1,979 full-time medical school faculty members, found that 48% of underrepresented minority respondents and 26% of non-underrepresented minority respondents “reported experiencing racial/ethnic discrimination by a superior or colleague.” Similarly, a 2009 physician survey found that 71% of black respondents, 63% of other race respondents, 45% of Asian respondents, and 27% of Latino respondents reported experiencing “racial/ethnic discrimination sometimes, often, or very often over their professional careers.” Moreover, between one-fifth and one-quarter of the physicians who self-identified as black, Asian, other race, or Latino “reported at least 1 job turn-over that they attributed to workplace discrimination.” A 2008 interview-based study of black, Latino, and Asian American physicians at the University of California, San Francisco, likewise noted, “Though often subtle, racial discrimination is perceived to occur in and have serious consequences for a career path, research success, and retention in faculty roles.”
And all too often racism—both from colleagues and patients—is far from subtle. In one recent article, a black female physician shared numerous episodes of overt racism during her medical school training at the University of Virginia. The author told of treating patients wearing confederate flags and being called a “colored girl” by a patient in the presence of attending physicians, who did not rebuke or even acknowledge the patients’ racist conduct or its impact on the author. The author also related that one attending physician referred to a Haitian patient as “Amadou Diallo”–the unarmed Guinean man who was shot and killed by New York City police officers in 1999—and said he would “stick the med student [the author] on him.”
These accounts just scratch the surface of the literature on racial and ethnic disparities in the medical profession. And the literature, in turn, may only scratch the surface of lived experience. But physicians confronting discrimination are not without recourse. Federal, state, and municipal antidiscrimination laws protect minority physicians from discrimination and harassment. Moreover, these laws protect physicians from retaliation for complaining about discriminatory conduct.
Any physician who has suffered discrimination should contact an employment attorney before taking any action. With sound legal advice, physicians can decide how to most effectively address discrimination at their home institution, up to and including filing a discrimination lawsuit. In light of the considerable evidence of racial and ethnic inequality in medicine, it is imperative that all physicians use all the tools at their disposal to stamp out discrimination.
 The study defined underrepresented minorities as “non-Hispanic Black; Mexican American and Puerto Rican Hispanic; Native American or Alaskan Native,” and defined non-underrepresented minorities as “Asian and other Hispanic groups.”