Table 1.
Recommendations to address Black physician experiences with anti-Blackness in healthcare systems through an ASA model
| Black Physician Experience Examples | Category | Recommendations |
|---|---|---|
| All pictures/names in the institution are of White men | Attraction | Change the pictures |
| Recruitment ads include images of White or White – presenting physicians | Attraction | Targeted recruitment |
| Blanketed diversity and EEO mission statements | Attraction | Develop statements that are inspirational, emphasize autonomy, and highlight multiculturalism |
| Interviewed by White men | Selection | Diverse selection committee |
| Professional norms are defined by whiteness (straight hair, suits, little make-up, speaking quietly) | Attrition | Culture change |
| Success not aligned with values (community, equity work, written work vs oral) | Attraction | Redefine priorities |
| Pay differences | Attrition | Change compensation metrics, transparency and accountability of compensation policies |
| Social support different (nepotism) | Attrition | Black centered programming |
| Black/minority tax | Attrition | Compensate, acknowledge the work |
| Reverse discrimination from AAP polices | Attraction | |
| Power/decision making with white men | Selection | Power redistribution |
| Bias/stereotypes (myth of meritocracy, laziness, have lower IQs) | Selection | Culture change, unconscious-bias trainings |
| Implicit White preference | Selection | Unconscious bias trainings |
| Lack of mentorship opportunities | Attrition | Mentoring programs including Black and non-Black mentors |
| Effects of colonial constructs | All 3 | Culture change, trainings, policy change |
| Unstructured interviews | Selection | Structured interviews |
| Organizations prioritize basic science vs community efforts | Selection | Reprioritize |
| “Ole boys networks” recruiting | Selection | Black medical colleges and medical associations |
| Black Physician Experience Examples | Category | Recommendations |
| Micro-aggressions and tokenism | Attrition | Cultural sensitivity and unconscious bias training |
| Admissions criteria based on standard test scores, best fit vs what one adds | Selection | Holistic review, training on unconscious bias, behavioral interviewing |
| Need to assimilate | Attrition | Culture change, trainings |
| Racially profiled in practices, clinics (assumed to be everyone but the physician) legitimacy of our presence | Attrition | Training, culture change |
| URM encouraged to apply in job ads | Attraction | Use multi-cultural language in recruitment ads |
| Illegal questions/microaggressions in questions | Selection | Standardized questions and structured interview |
| Video interviews: video cameras programmed to recognize Whiteness and White skin as the default | Selection | Training sessions to conduct video interviews and raise awareness of biases |
| Lower job satisfaction and affective commitment | Attrition | Cultural change |
| Digital redlining | Selection | Training and awareness of digital redlining, providing “quiet” places for interviews |
| Lack of leadership opportunities | Attrition | Transparency and accountability in promotion policies, revamp policies |
| Toxic working environments and cultures | Attrition | Leadership buy-in, equitable power and influence for Chief Diversity Officer |
| High turnover and burnout | Attrition | Culture change, diversity trainings |
| Bias practices in publication, grants, awards, compensation | Attrition | Revamp criteria |