Behind The Scenes In Medicine: Exposing Racism in Big Corporate Healthcare
I am a Black pediatric eye surgeon, and one of the first Black doctors to lead any department within Sutter Health, Palo Alto Medical Foundation, and Palo Alto Foundation Medical Group (collectively, “Sutter”). Sutter is one of the largest healthcare providers in California, serving 3.5 million members and employing over 55,000 people. Unfortunately, Black doctors have been fighting for basic fairness at Sutter for a long time, and it has only gotten worse in the last year.
Sutter’s Black doctors have experienced a workplace that devalues Black professionals. The glass ceilings curtail our careers, are unfair to us, and weaken our institution as a whole. Overt acts of anti-Black racism committed by Sutter leaders traumatize our amazing colleagues and demoralize us when we see their racial trauma. These acts create a toxic workplace , and going through these experiences have taken a huge toll on us Black doctors. Many of us have left because we feel so unwelcome at Sutter, with a resulting incalculable cost to society.
I, and other Black doctors, have spent years trying unsuccessfully to work for positive change within the system. But after watching countless Black and allied colleagues raise diversity concerns, which leadership advised were unwelcome and which led to multiple incidents of retaliation, I’ve reluctantly concluded that Sutter will not authentically embrace Black professionals through internal channels. Because I do not think there is any other viable means for effecting change, and because so many of my colleagues are not able to raise their voices for fear of further retaliation, today I stepped forward to file a lawsuit seeking accountability and reform at Sutter.
Like other Black and allied doctors at Sutter, I have one goal: to be able to provide excellent patient care in an environment where Black doctors do not have to battle leadership for basic fairness and equal opportunity. As I have alleged in my complaint, this is difficult given the rampant racial stereotyping and double standards. For example, a disproportionate number of doctors of color at Sutter have been required to meet with Sutter’s disciplinary committee and/or put on Performance Improvement Plans for advocating for ourselves or our patients; have had our income reduced, lost pay opportunities provided to white doctors, and been denied promotions; or have been asked to leave or forced out through hostility, scrutiny, or absurd discipline.
Sutter leaders have indicated that they do not think there should be more Black doctors than the number of Black patients (a paltry 2%), reflecting assumptions about whether we are suitable to treat deserving patients of other races. And we’ve been called “aggressive” for asking staff to complete routine patient procedures (as needed for the job), challenged as not belonging when we enter the building, and exposed to racist comments about the communities around us, such as that people of color “live in the ghetto.” We have been disciplined for “looking tired” or for “being perceived as intimidating,” and warned that raising concerns about racism is hostile. Even requests for greater focus on diversity and inclusion — especially in the wake of the murders of George Floyd, Ahmaud Arbery, Breonna Taylor, and countless others — are labeled as tantamount to “anti-white racism.” We have been denigrated for wearing our African hair naturally at work. Not surprisingly, if any of us complains about our treatment, our tone is unwelcome and subjects us to more discipline.
My Black colleagues have worked extraordinarily hard over the course of their medical careers only to find opportunities for them impeded and their energies zapped by the indignities at work. Currently there are no Black leaders in Sutter’s senior ranks. Moreover, there are only three Black doctors out of the 354 doctors in any leadership position across the organization, and they hold positions at the lowest tier of leadership. In order to survive at Sutter, Black doctors urge each other to keep our heads down and remain unseen. Unsurprisingly, I have observed that Black doctors leave Sutter at higher rates than white doctors.
My own story within this environment follows a predictable pattern. Sutter has held me out as the poster child for the organization’s commitment to diversity internally and to philanthropy in the outside community. Yet Sutter’s leaders have interfered with and stalled my career advancement, scapegoated me for the bad management decisions of Sutter’s majority white leaders, demoted me, and subjected me to racial hostility and bias, including through unfair and retaliatory discipline when I have dared to ask to be treated fairly.
As my career at Sutter unraveled due to racial bias, I kept pushing on — ever believing that the workplace would be fixed. It never was.
Because I work at Sutter and have a long career ahead of me here, I am invested in a fair workplace. To be clear, helping young children protect their eyesight and reach their full potential is the highest honor of my life. For almost 13 years, I have provided care to thousands of children in California and throughout the United States. I have given this my all. And I have been privileged to be recognized with teaching awards, quality of care awards, and community service awards from universities and community non-profit organizations. In 2016, Sutter even awarded me its first ever Community Service Award for my charitable services for blind children in East Africa and here at home, at Zuckerberg San Francisco General Hospital. In 2015, I became the first Black surgeon to be appointed Chair of the Department of Ophthalmology. At that time, I was the first — and to this day last — Black physician to chair any department within Sutter’s Palo Alto Medical Foundation, which is located in over 2 dozen California cities and currently employs nearly 1800 doctors.
My experience of reaching the pinnacle of patient service while fighting racism from leaders has led me to conclude that Sutter expects a Black doctor like me to be either a perfectly passive token or a “disruptive problem” — with no in-between. Trying to surf around these stereotypes is unfair and exhausting. Such dehumanizing treatment also stands in the way of Sutter’s stated desire for diversity and inclusion. We are not “problems,” we are Black doctors who face problems, at Sutter. I am asking Sutter, for the sake of myself and of other Black and allied doctors, to please do better and together with us, face its continuing historical problems. We don’t want to be given any special treatment. We want to be able to give: fully, equally and fairly, of our skills and talents, for the health and healing that all people deserve and need. As doctors, our shared impulse for equity and love of healing can help us willingly face these ills and so cure them, and each other.
To this end, the collective experiences of Black doctors help point to the below ways to properly pair the responsibilities of leadership with the rights of all doctors to flourish in an affirmatively anti-racist healthcare workplace:
> Welcome a restorative process for Black doctors and other doctors of color to reconcile the racial harms we have endured at Sutter. This will help educate Sutter on its institutional blinders to both pointed and ambient racism in our workplaces.
> Abandon or reform workplace policies that have long reinforced structural racism in healthcare. Recognize that Sutter’s recent actual intensification of those policies in response to this challenge only worsens grievances, hampering positive change.
> Stop disciplining doctors of color for our tone, unfair perceptions of us, or for our complaints about discrimination.
> Appoint an independent ombudsperson to whom doctors can report instances of race bias or harassment.
> End sham outside investigations or sham organizational mediators to whitewash race issues.
> Commit to diversity that celebrates peoples’ differences and ideas without behind-the-scenes enforcement of conforming homogeneity; equity that equally values diverse doctors’ different wants and needs; and inclusion that stops excluding already underrepresented doctors.
> Grow the bench of Black leaders in the organization.
> Recruit more Black doctors beyond Sutter’s 1% representation, which is well below national average.
> Re-examine of the use of racially biased customer surveys which are used to punish doctors of color.
> Review the pay and promotion decisions affecting Black doctors, with prompt remediation of problems.
Unexamined — or worse — glossed over, these culture problems will continue to cast an exclusionary shadow over an alternative vision of diverse doctors working freely towards a united healthcare future for ourselves, our patients, and the communities we serve.
In remembrance of Juneteenth, I step forward today to file this suit https://www.lieffcabraser.com/pdf/sutter-race-discrimination-complaint.pdf to help bring an end to Sutter’s racism against me and my talented Black colleagues.
