Disclosures: The authors report no relevant financial disclosures.
October 18, 2021
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Perception of discrimination common among cardiologists

Disclosures: The authors report no relevant financial disclosures.
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More than 50% of cardiologists from historically underrepresented racial or ethnic groups reported experiencing discrimination during their career, according to results from a survey.

In addition, women were more likely than men to report experiencing discrimination, according to the 2015 American College of Cardiology Professional Life Survey, which was conducted by the ACC Diversity & Inclusion Task Force and the ACC Women in Cardiology Section and published in the Journal of the American College of Cardiology.

Graphical depiction of data presented in article.
Data were derived from Thomas KL, et al. J Am Coll Cardiol. 2021;doi:2021.09.002.

“Despite calls for racial and ethnic diversification in medicine or cardiology, there has been little change. Putting into place methods to support those who are underrepresented in medicine is critical moving forward,” Kevin L. Thomas, MD, FACC, associate professor of medicine at the Duke University Research Institute, said in a press release.

The survey included responses from 2,245 cardiologists (58% men; 83% to 85% adult cardiologists). Among the cohort, 1,447 identified as white, 564 as Asian/Pacific Islander, 37 as multiracial and 197 as a member of an historically underrepresented racial or ethnic group. Of the latter group, 80 were Black, 113 were Hispanic and four were Native American.

Reports of discrimination

Compared with white respondents (36.4%), more respondents from historically underrepresented racial or ethnic groups (52.3%) and Asian/Pacific Islander respondents (45.5%) reported they experienced discrimination (P for both < .001), according to the survey.

In addition, women (range by racial/ethnic group, 57% to 69.2%) were more likely to report experiencing discrimination than men (range by racial/ethnic group, 13.9% to 44.6%), Thomas and colleagues found.

Among male respondents, those from historically underrepresented racial or ethnic groups (44.6%) and Asian/Pacific Islander respondents (36.2%) were more likely to report experiencing discrimination than white respondents (13.3%; P for comparison across all racial/ethnic groups < .001).

However, among female respondents, white women (69.2%) were more likely to report they experienced discrimination compared with those from historically underrepresented racial or ethnic groups (62.7%) and Asian/Pacific Islander respondents (57%; P for comparison across all racial/ethnic groups < .001), according to the researchers.

Regarding types of discrimination reported, men were most likely to report race- or religion-based discrimination, whereas women were most likely to report sex-based discrimination, followed by parenting-based discrimination, the researchers wrote.

Among the cohort, 53% reported discrimination affected relationships with colleagues and 22% reported it affected relationships with patients; those results were consistent across races/ethnicities.

Three-quarters of respondents reported they had a mentor during training, and Asian/Pacific Islander respondents were more likely than white respondents to report their mentor had a positive influence on career planning and decision-making (74% vs. 67%), according to the researchers.

Compared with white cardiologists, those from historically underrepresented racial or ethnic groups were less likely to prioritize salary (13.6% vs. 20.6%), benefits (10.9% vs. 23.3%) or work hours (19.3% vs. 31.3%) in their first job after training (P for all < .02), Thomas and colleagues wrote.

In negotiations for subsequent jobs, compared with white cardiologists, those from historically underrepresented racial or ethnic groups were more likely to prioritize salary, benefits and work hours, whereas those from historically underrepresented racial or ethnic groups and Asian/Pacific Islander cardiologists were more likely to prioritize travel benefits, diversity, mentoring, workspace, time to promotion advancement, academic rank and roles with recognition (P for all < .01), the researchers wrote.

Rates of burnout were higher among white cardiologists (30.3%) compared with those from historically underrepresented racial or ethnic groups (22.4%; P = .02) and Asian/Pacific Islander cardiologists (20.1%; P < .01), and white cardiologists were more likely than those from other backgrounds to report that their job caused “a great deal of stress,” Thomas and colleagues wrote.

Recommendations for improvement

The authors issued four recommendations in response to the results:

  • Collect sex and racial/ethnic identity using classifications similar to those in the 2020 U.S. Census.
  • Partner with racial- and ethnic-specific organizations on strategies to improve racial and ethnic diversity and inclusion in cardiology.
  • Implement training on implicit bias and antiracism for leaders of institutions and organizations.
  • Develop leadership pathways for women and those from historically underrepresented racial or ethnic groups.

Reference:

  • American College of Cardiology. Survey: More Work Needed to Combat Discrimination, Inequity in Cardiovascular Workforce. Published and accessed Oct. 18, 2021.