Concepts in Practice: Understanding and Addressing Name-Based Microaggressions in Health Care

Names are important markers of identity, culture, and belonging. In health care settings, individuals with ethnically distinct names may experience repeated mispronunciations, unsolicited nicknames, or avoidance of their names. Repeated mispronunciations without sincere efforts to learn or improve, as well as the avoidance, dismissal, or replacement of names with unsolicited nicknames, may function as name-based microaggressions and can negatively affect psychological safety, professional identity formation, and workplace inclusion. In this manuscript, we discuss the effect of name-based microaggressions on health care professionals and trainees, with particular focus on the emergency department. We review the 3 major categories of microaggressions-microassaults, microinsults, and microinvalidations-and use clinical vignettes to demonstrate how these behaviors may appear in both interpersonal and institutional settings. We also propose practical interpersonal and institutional strategies to promote more inclusive workplaces and foster respectful engagement with ethnically distinct names. By encouraging greater awareness, curiosity, humility, and intentionality around names, health care organizations can help cultivate clinical environments where individuals feel respected, included, and valued.