Background: Discrimination is rampant in our society and remains a persistent topic given our current political climate. A meta-analysis in 2011 documenting discrimination amongst all levels of health care providers showed a prevalence of verbal abuse of 63%, gender discrimination 54%, and racial discrimination 24%. The purpose of our study is to identify the magnitude of discrimination against health care professionals in the work place and explore resources available to mitigate and deal with discrimination. Our goal is to help lay the foundation for establishing novel hospital policies and protocols in regards to racism and discrimination.
Methods: We designed a five minute anonymous, voluntary, cross-sectional, electronic survey distributed to health care professionals in the department of medicine at New York Presbyterian-Weill Cornell Medicine in 2019. Champions were identified in each department (ie nursing, physicians, etc.) who sent an email link of the survey to their department employees. Biweekly reminder emails were distributed and the survey was not incentivized. Responses were collected using the IRB-approved, web-secure REDCap database. The data was collected in REDCap to a secure password-protected research server managed by the Division of General Internal Medicine.
Results: Over 400 health care providers were surveyed with 22% of general internal medicine physicians and hospitalists, 18% residents, 27% nurses/nurse’s aide, 18% social worker/care coordinators, 9% physician assistants, and 6% clerks. Of those, 69% were women, 31% were male, and 51% were white/Caucasian, 22% Asians, 17% African Americans and 10% others. Fifty one percent of health care providers felt they were discriminated by patients and families based on race and ethnicity, 42% discriminated based on gender, and 47% discriminated based on age. Furthermore, 30% felt discriminated by other hospital employees, while 27% were discriminated based on gender, and 30% based on age. Fifty seven percent of providers felt that these discriminatory experiences by patients, families, and other health care professionals caused significant distress and 42% felt their confidence was compromised in the work place. Shockingly, 18% of respondents considered leaving their job. When asked about the policies and resources available to them to help counter these experiences, 44% were not aware of any formal policy and 64% were unaware of an Ombudsman office. Lastly, the majority of providers (83%) felt that more resources were necessary to help address discrimination.
Conclusions: Our study exposed the extent of discrimination health care providers face on a daily basis. It is important to acknowledge the existence of discrimination in the hospital and measure its magnitude as a metric for assessing improvements in the workplace culture. This highlights the need for stronger and more effective institutional policies and resources to support faculty. Moving forward, we plan to expand our survey to the national level to quantify the overall extent of discrimination in health care.