Micro‐inequities in Medicine

Silver, Julie K.; Rowe, Mary Budd; Sinha, Michael S.; Molinares, Diana; Spector, Nancy D.; Mukherjee, Debjani

doi:10.1016/j.pmrj.2018.08.382

Cited by 33 publications

(20 citation statements)

References 16 publications

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“…92 Women physicians do not equitably receive recognition awards, [93][94][95][96] and there are troubling disparities in speaking, 94,95 publishing, 97,98 and leadership opportunities. 99,100 Organizational barriers 101 and implicit bias 94,102 are often cited as major contributing factors supporting ongoing disparities for women in medicine.…”

Section: Physicians From Underrepresented Groups and Risk For Leavingmentioning

confidence: 99%

Physician Workforce Disparities and Patient Care: A Narrative Review

et al. 2019

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Background: Ensuring the strength of the physician workforce is essential to optimizing patient care. Challenges that undermine the profession include inequities in advancement, high levels of burnout, reduced career duration, and elevated risk for mental health problems, including suicide. This narrative review explores whether physicians within four subpopulations represented in the workforce at levels lower than predicted from their numbers in the general population-women, racial and ethnic minorities in medicine, sexual and gender minorities, and people with disabilities-are at elevated risk for these problems, and if present, how these problems might be addressed to support patient care. In essence, the underlying question this narrative review explores is as follows: Do physician workforce disparities affect patient care? While numerous articles and high-profile reports have examined the relationship between workforce diversity and patient care, to our knowledge, this is the first review to examine the important relationship between diversity-related workforce disparities and patient care. Methods: Five databases (PubMed, the Cochrane Library of Systematic Reviews, EMBASE, Web of Knowledge, and EBSCO Discovery Service) were searched by a librarian. Additional resources were included by authors, as deemed relevant to the investigation. Results: The initial database searches identified 440 potentially relevant articles. Articles were categorized according to subtopics, including (1) underrepresented physicians and support for vulnerable patient populations; (2) factors that could exacerbate the projected physician deficit; (3) methods of addressing disparities among underrepresented physicians to support patient care; or (4) excluded (n = 155). The authors identified another 220 potentially relevant articles. Of 505 potentially relevant articles, 199 (39.4%) were included in this review. Conclusions: This report demonstrates an important gap in the literature regarding the impact of physician workforce disparities and their effect on patient care. This is a critical public health issue and should be urgently addressed in future research and considered in clinical practice and policy decision-making.

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Section: Physicians From Underrepresented Groups and Risk For Leavingmentioning

confidence: 99%

Physician Workforce Disparities and Patient Care: A Narrative Review

et al. 2019

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“…Research on gender disparities demonstrates a spectrum of inequities that range from microinequities to macroinequities, 25 with the latter having easily identifiable and quantifiable metrics (e.g., compensation or promotion). While studies of microinequities are frequently quantitative and report data, the metrics used are often unique and sometimes quite creative.…”

Section: The Inequity Spectrummentioning

confidence: 99%

Understanding and addressing gender equity for women in neurology

Silver

2019

Neurology

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Despite the fact that the percentages of women among physicians and neurologists have been rising, gender-related disparities in numerous metrics persist, notably in compensation, promotion, funding, recognition, leadership, publishing, and speaking. Simultaneously, women working in academia, including medicine, face high rates of sexual harassment. Leaders of all health care-related organizations must accept the moral and ethical imperative to expeditiously address both gender-related discrimination and harassment (inclusive of but not limited to sexual harassment) of women in medicine. At this unique time in history, there is an opportunity for leaders in neurology to strategically accelerate efforts to address workforce gender disparities and ensure harassment-free training and work environments. Leaders will have to plan an intentional path forward, using a systematic process, metrics, and strategies unique to their own organizations, to overcome barriers to an equitable and safe work environment for women. Moreover, leaders in 4 gatekeeper organizations—medical schools/academic medical centers, funding agencies, journals, and medical societies—must hold each other accountable for gender equity as their own success and financial return on investment is dependent on the efforts of those in the other categories. In short, the path forward is to focus on ethical principles and behavior when it comes to addressing workforce gender disparities for women in medicine.

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“…Women physician leaders protect patients and health care workers by promoting a perspective that is sorely lacking today. Dr. Julie Silver's Be Ethical Campaign lays out a scientific methodological framework on which to build gender equity in every organization (Silver et al 2018b). Cringing about physicians' ethical violations is not enough.…”

Section: Physician Sexual Assault: the Moralmentioning

confidence: 99%

Physician Sexual Assault: The Moral Imperative for Gender Equity in Medicine

Burgart

2019

The American Journal of Bioethics

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Micro‐inequities in Medicine

Cited by 33 publications

References 16 publications

Physician Workforce Disparities and Patient Care: A Narrative Review

Physician Workforce Disparities and Patient Care: A Narrative Review

Understanding and addressing gender equity for women in neurology

Physician Sexual Assault: The Moral Imperative for Gender Equity in Medicine

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