Physician Workforce Diversity and Absence of Fairness
Absence of fairness is the fifth driver of burnout identified by Maslach and Leiter in their book The Truth About Burnout. In my last blog post, which was way too long ago on January 5th, I discussed opportunities for leaders to spend some time with front line clinicians to show respect and better understand their challenges.
Another key element of fairness, particularly as the physician workforce becomes more diverse, is being treated equitably regardless of personal factors that are not related to job performance.
These were best articulated by Paul O'Neill, the former CEO of ALCOA and former Secretary of the Treasury under George W. Bush. He said, “I believe an organization has the potential for greatness if every person can say yes to three questions without reservation." The three questions are:
“Can I say every day I am treated with dignity and respect by everyone I encounter without respect to my pay grade, or my title, or my race, or ethnicity or religious beliefs or gender?
I given the things I need – education, training, tools, encouragement – so I can make a contribution to this organization that gives meaning to my life?
Am I recognized for what I do by someone I care about?”
That first question is the one I'd like to focus on. It's a key question to evaluate personal and emotional safety in the workplace, whether everyone is treated fairly.
Some might wonder what I could have to say about this. After all, I describe myself as a "pale, stale, male" -- an older white guy who never had to deal with discrimination in my medical career. I never was made to feel that I had to be better than others just to be considered equal. I've never been mistaken for a nurse or a therapist, never had a patient question my care because of my appearance, never been passed over for an opportunity that went to others less qualified, and never felt targeted, intentionally or inadvertently, by comments of my co-workers.
If you spend a little time on Twitter searching for keywords like #diversityinmedicine you'll find an array of excellent physicians from a variety of diverse backgrounds who are making significant contributions to medicine, both in advancing science and in making patient care more humane and inclusive. Many of them also relate stories of being treated in the ways that I described above.
It's not easy being different. It can lead to a higher likelihood of burnout, carrying the added burden of difference and/or discrimination.
On the positive side, diversity is good for patients. Studies have shown that patients comply better with recommendations from physicians who they can personally relate to, who look like them.
I am working on myself to ensure I'm helping move the needle towards a more inclusive and diverse physician workforce. I look back and realize despite considering myself enlightened, if not fully WOKE, I've made comments inadvertently that have likely hurt my colleagues.
Now, when I present on the drivers of burnout, I talk about the growing positive influence and challenges of our increasingly diverse workforce and the impact of absence of fairness. I recognize that I'm not the most qualified to discuss the topic, but also know that none of us can ignore it.
What do you think? I'd appreciate any comments about this issue, as well as any recommendations about how I, as a pale stale male, can better help create a safe and healthy workplace for everyone.