Risk factors associated with professional consequences in a cohort of black physicians

Physicians underrepresented in medicine are more harshly punished, receive less appropriate guidance/coaching, and experience more attrition than other physicians.

To determine factors in the clinical work and learning environment that are associated with black physicians who experience disciplinary actions, professional misconducts complaints and lower rank assumption.

Prospective survey study was sent to members of the National Medical Association in March to May 2023. The survey included: demographic factors; Professional consequences defined as those who had disciplinary actions, complaints of professional misconducts or lower rank assumption, workplace resources; perceived stress scale; sources of stress in professional and personal life; self-defined burnout; stereotype threat; perceived discrimination survey and psychological Safety. Statistical Analysis done and p < 0.5 taken as significant.

Of 176 respondents; professional consequences occurred in 79 (45 %) who were more likely to come from Western US region and were females. Those with professional consequences scored significantly higher on Stereotype threat (71% versus 31%, P < 0.001), Stigmatization/devaluation (9% vs. 0%, p = 0.004), Exclusion rejection (41% vs. 4%, p < 0.001) and Discrimination at work/school (28% vs. 1%, p < 0.001) and significantly lower on psychological safety (32% vs. 56%, P = 0.001). They also scored significantly higher on burnout (66% vs 30%, p < 0.001), high stress (89% vs 54%, p < 0.001) and high work factors contributing to stress (24% vs 4%, p < 0.001), but significantly lower on accessing institutional wellness resources (18% vs 40%, p < 0.002), initiating back-up systems without negative consequences from supervisors(42% vs 69%, p < 0.001), and without negative consequences from peers (41% vs 75 %, p < 0.001) CONCLUSIONS: Black physicians with professional consequences are more likely to be female, practice in Western US and perceive the clinical workplace as hostile and unsafe. These physicians are more burned out, stressed and unable to access institutional support resources. Early identification, coaching and scaffolding of these at-risk physicians and learners is urgently required.