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Background Workplace discrimination negatively affects physicians of color personally and professionally. Although the occurrence of discrimination from patients has been visible in social media, popular press, and personal essays, scant research exists on patients as a source of discrimination directed at physicians of color. Objective To explore practicing general internists’ experiences observing or interacting with patients exhibiting discriminatory behavior directed at physicians of color. Design A qualitative study with in-depth, semi-structured, one-on-one telephone interviews conducted and recorded between May and September 2019. Participants A purposive sample of 24 general internists practicing at 12 academic health centers in the USA: 14 self-identified as White and 10 as a physician of color, which included Asian, Black, Native American, and self-identified other race. Approach Four coders analyzed the transcribed and verified interview text; thematic analysis was used to inductively identify cohesive themes and subthemes. Key Results Analyses revealed four major themes: (1) assumption that a legitimate doctor is White, male, and able-bodied; (2) legacy of the Black experience; (3) working through the struggle of discrimination; and (4) ethical dilemma of providing care to discriminatory patients. In addition to discrimination from patients based on a physician’s race or ethnicity, participants described experiencing or observing discrimination based on a physician’s gender and disability status. Participants generally expressed a need for greater support from colleagues and more guidance from institutional policies. Conclusions General internists practicing in academic settings reported observing or experiencing discrimination from patients based on the physician’s race, ethnicity, gender (or their intersection), and disability status and the ethical dilemma of providing care to such patients. These results contribute to growing evidence of the need for institutions to better support an increasingly diverse physician workforce with policies and specific guidance to help physicians respond to discrimination from patients while still providing quality care. Supplementary Information The online version contains supplementary material available at 10.1007/s11606-021-06696-7.

The objective of this study was to assess the effects of captive bolt length and breed type on post-stun leg activity in cattle. A total of 2850 Holstein (HOL) and non-Holstein British/Continental bred (NHOL) steers and heifers were observed post-stunning at a large commercial slaughter facility. A pneumatically powered penetrating captive bolt stunner was used with three different bolt lengths: CON, 15.24 cm; MED, 16.51 cm; and LON, 17.78 cm. Hind limb kicking, forelimb activity, take away belt stops, carcass swing and number of knife sticks during exsanguination were recorded for each animal from video recording. Hind limb and forelimb kicks observed ranged from 0 to 25 and 0 to 8, respectively. Analysis of post-stun hind limb and forelimb activity indicated that increasing pneumatically powered penetrating captive bolt length does not decrease post-stun leg activity. There was a higher percentage of cattle experiencing take away belt stops and carcass swing in HOL as compared with NHOL.

The COVID-19 pandemic had significant consequences on cattle slaughter capacity in the United States. Although industry stakeholders implemented strategies to minimize cattle welfare impacts of increased weights, days on feed (DOF), and increasing temperatures, there were concerns that mobility challenges would be observed at slaughter facilities. The objectives of this study were to characterize mobility in fed cattle during this recovery period and to identify factors impacting mobility. A total of 158 groups of cattle (15,388 animals) from one slaughter facility were included in the study. A 4-point mobility scoring system was used to assess cattle mobility. Cattle at the facility with normal mobility scores were reduced from the historical average of 96.19% to 74.55%. No increase in highly elevated mobility scores was observed. Mobility was impacted by weight, temperature humidity index (THI), distance hauled, sex, and DOF, with results differing by mobility category. Weather was a key contributor to mobility challenges; the relative risk of observing an elevated mobility score was 45.76% greater when the THI changed from No Stress to Mild Stress. Despite the challenges that the industry faced during this period, efforts to minimize negative effects on cattle welfare by enhanced focus on low-stress handling were effective.

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