A Story of Bias and Prejudice in Medicine Highlighted by #WhatADoctorLooksLike
Dr Tamika Cross' event went viral with “#WhatADoctorLooksLike”.
An inflight medical emergency occurred on Delta flight 945 from Detroit to Houston. Dr Tamika Cross, of Meharry Medical College, offered her expertise as a physician to aid in this situation. Her offer was declined due to the fact that a white man, who did not declare his title, was preferred over her in this particular circumstance. This striking story, along with an analysis of inherent bias and prejudice, was recently published in JAMA.1
Dr Tamika Cross is a black woman, currently practicing in obstetrics and gynecology as the administrative chief resident at the University of Texas in Houston. This event went viral with “#WhatADoctorLooksLike” – which brought forth similar stories with an underlying theme of individuals being discredited due to skin color and/or gender. JAMA discussed the data from 3 articles that addressed the inherent gender and racial bias in the medical field. The articles shared a commonality that bias against women exists in social settings; however, discrepancies exist based on studies analyzing the performance of women and men in the medical field.
“Although the scores for men and women at the PGY-1 [post-graduate year 1] level were comparable, the scores for PGY-3 [post-graduate year 3] men were higher than those of PGY-3 women across all 23 sub-competencies. If bias against women exists, why was it not seen at the PGY-1 level?” This raised concerns because it disproved the pre-conceived notion that men are indeed more equipped to carry out medical tasks.
Discrimination, prejudice, and stereotypes are ingrained in people from nurture, as people are not born with convictions. A mother explained in JAMA how she participated in a show-and-tell — bringing with her a stethoscope to explain her job as a physician. “When I explained that I was a physician, one of the children objected. His argument being, 'Boys are doctors; girls are nurses.'” Women and minorities have found their futures to be determined by old social norms, such as being expected to become "housewives," and later on experience the trend of acquiring positions subordinate to men.
Inherent biases cannot be completely eliminated as they are historic trends that continue to prevail; however, “the first step is to identify our own implicit biases. Although this can be uncomfortable, it is the first step in recognizing our own ideas of what a doctor looks like; these biases can powerfully influence our ideas about which medical students deserve consideration for AΩA [Alpha Omega Alpha Honor Medical Society], how our residents are progressing, and who should be invited to give grand rounds,” the researchers commented. By acknowledging one's own implicit feelings toward people of different gender, race, and religion, one can create a more inclusive community.
Departments of medicine saw an upturn at the end of the last century in the number of women excelling in the field, which was predominantly composed of white males. “We must insist that our profession and the process that our trainees encounter along the way treat them fairly and reflect the diversity of the patients we serve.”
- Cooke M. Implicit bias in academic medicine #whatadoctorlookslike. JAMA Intern Med. 2017;177(5):657-658. doi:10.1001/jamainternmed.2016.9643