Why recognizing stereotypes in the workplace is necessary

Barriers and biases still exist in healthcare.

It’s 635 pm, 5 minutes past the start time for our meeting. I sat in a sparse conference room, eagerly waiting for the head doctor to enter. Today I would be introduced to the rest of the group as the new attending neurologist.

All roads were leading to this. Leaving the country to obtain my medical degree, followed by intensive residency and fellowship training. This was the meeting I had envisioned my whole life. Being introduced as an attending physician. The person who wears the long white coat during medical rounds and has the final word. Every sacrifice had led to this.

I saw the head neurologist enter the room. “Let’s start the meeting,” he said. “The first item on our agenda will be welcoming our new doctor. She is the chocolate of our group.” Suddenly, I felt my face become flushed. Did he just call me chocolate? I mean, I like chocolate, but did I just get introduced as a chocolate? Is it because I’m brown? Or a woman? I heard a few gasps, followed by further explanation, “Well, I mean, she’s the chocolate of the group, you know, like a flower.”

The following day the doctor approached my office and stammered, “I hope you don’t mind that thing I said, you know, about how you’re a chocolate.” I said, “What thing? I forgot all about it!” The truth is, I hadn’t forgotten about it. But in an effort to fit in, and not create any controversy, I chose to remain silent.

I realized at that moment that I had already been categorized. As the “chocolate,” the sweet woman who wouldn’t make a fuss. Unfortunately, this was not new to me. Throughout my career, my categorization as a young, woman doctor has followed - at times subtle, other times less so, yet always pervasive.

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I had become all too accustomed to entering a patient room and being mistaken for a nurse, medical assistant, anything other than the physician. Conversations all too often started off with, “you are too young to be a doctor!” Most concerning was the categorization by fellow physicians, including women doctors. During several job interviews, I was asked about marital status, if I have children, and if not, was I planning on having children. These questions became so frequent I began to think they were normal, until I mentioned this in passing to my non-medicine husband who cried out, “they can’t ask you questions like that!” My response was, “Well, they do.”

Social characterization, the process of placing individuals into social groups, is a natural and early learned process. Classifying people into groups, whether by gender, occupation or age, enables us to help us organize our world. On the flip side, social characterization leads to stereotyping and prejudice.

Examples of stereotyping and the so-called “gender gap” have been recognized in the field of academic medicine. Julia Files, a professor of medicine at Mayo Clinic Arizona, noticed that she was called “doctor” less often than her male colleges. After confirming her suspicions with other female physicians, she conducted a study testing her hypothesis that women doctors were less frequently referred to by their formal title at weekly Internal Medicine Grand Rounds. Interestingly, she found that male introducers used the formal title for other men 72.4 percent of the time, but only used formal titles for women 49.2 percent of the time. Files results highlighted that although gains have been made in representation of women in medicine, differences in perception and treatment of males versus female physicians still exist.

Data from AAMC analysis also reflects that although almost half of all medical school students are women, they are less likely than men to be full medical school professors. This bias has been seen when considering peer reviews as well. Invited peer reviews for scientific journals help scientists advance their career, hone writing skills, and build relationships with other colleagues. Unfortunately for women, they are less likely to be invited and participate in peer reviews.

Since we know that characterizations and stereotypes exist, what can we do about them? As most of our biases are subconscious, recognition of potential bias is crucial in mitigating future bias. National Academy of Sciences has also acknowledged negative stereotypes in women scientists, and recommends several interventions to reduce its impact. So, let’s bring the subconscious to the consciousness, regardless of the characterization, and know that awareness is the key. Only once recognition happens can we take steps for change.

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