Bias, Burnout, Race: What Physicians Told Us About the Issues

Carol Peckham

Disclosures

January 10, 2017

In This Article

Introduction: Physician Burnout, Bias, and Race/Ethnicity

This year we published the sixth annual Medscape Lifestyle Report, a major survey of physicians asking about their health and happiness in relation to a range of other factors. This year, as in previous reports, we examined the current state of physician burnout and bias, and how they might influence physician attitude and behavior. And, for the first time, the Medscape survey asked more than 14,000 physicians from over 30 specialties how they describe their own race or ethnicity in order to identify associations, if any, with the responses to other questions.

The Medscape survey used race and ethnicity criteria set by the US Census Bureau.[1] This is a subjective question, and ethnicity and race are not straightforward, so respondents were allowed to choose more than one option, which 5% did. Given such limitations, the answers still provide some insight into how physicians might view themselves. In the survey, the majority (68.6%) of physicians reported that they are white/Caucasian. The next most prevalent racial group was Asian (19.1%), although ethnicities within this group varied, with Asian Indians being the most represented (8.3%).Only 5.2% of physicians reported as Hispanic/Latino and 3.6% as black/African American.

Data from the Association of American Medical Colleges (AAMC)[2] on US medical school enrollment between the 2013-2014 and 2016-2017 school years found very little change in the percentages of the major racial groups over this period of time. In the AAMC report, 53% of graduates were white (declining slightly over 5 years from 56%). About 20% of graduates were Asian, 7% were black/African American, and 6% Hispanic/Latino.

The proportion of black/African American and Hispanic/Latino physicians within the entire physician population does not necessarily reflect the overall proportion of these ethnicities within the general population. Only about 9% of all US physicians identify as black/African American, American Indian or Alaska Native, or Hispanic/Latino, according to the AAMC data.[3] Although black/African American citizens make up about 13% of the US population, they account for only 4% of the US physician workforce.

A 2007 study suggested that major barriers to increasing the number of black/African American physicians include financial constraints, lack of role models and exposure to medicine as a career, little encouragement either at home or in school, and negative peer pressure.[4]

Physician Race/Ethnicity and Gender

According to this year's Medscape report, black/African American physicians include the highest percentage of women (67%), while the lowest percentage is among whites/Caucasians (36%). This result is generally supported by the AAMC, which has found a steady increase in women among black/African American physicians over time, with women currently representing about two thirds of black/African American medical school applicants. AAMC reports this same trend for all younger non-white physicians (those under 29 years), with women now outnumbering men 52% to 48%.[3]

Among Asian physician subgroups responding to Medscape's survey, the only group with more women than men is Filipino physicians (56% to 44%). These findings are also supported by the AAMC,[3] which reported men outnumbering women among all Asian ethnic groups except for Filipino physicians.

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