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When Dr. Onyeka Otugo, an African American physician, was in training in emergency medicine, she was often mistaken for a janitor or food service worker—even after explaining that she was a doctor.
While some may see this mix-up as an innocent mistake, such exchanges can be considered microaggressions, and they are all too common in healthcare.
The term “microaggression” was coined in the 1970s by a Harvard University professor of education and psychiatry. It entered more mainstream use in the past decade as way to describe comments or actions that subtly and often unconsciously or unintentionally expresses a prejudiced attitude toward a member of a marginalized group.
New research has found that a staggering 94% of female surgeons and 81% of racial/ethnic minority surgeons have experienced microaggressions in the workplace. These microaggressions were found to have a “crucial association” with physician burnout and can also lead to long-term psychological distress.
Here’s how you can respond to workplace microaggressions from both perspectives, how to identify a microaggression, and how to be an ally in the workplace.
How To Handle Microaggressions in the Workplace
For targets of workplace microaggressions, it can be difficult to determine how to respond to the perpetrator in an appropriate and polite manner.
In 2021, ACS released a two-part webinar series on how to manage and cope with microaggressions. Dr. Cherisse Berry, an associate trauma medical director and assistant professor of surgery at the New York University School of Medicine, suggested using the GRIT method when determining how to best respond to the perpetrator:
- Gather your thoughts – don’t react with anger; decide if this is the appropriate time and place to address the potential microaggression.
- Restate the comment or ask the speaker to restate it – this will allow the speaker to realize the impact of their words or actions and allow them to clarify if needed.
- Inquire – seek deeper clarification. Ask the speaker to help you understand what they meant by their statement. However, try not to be judgmental and make the comment about the person, but focus on addressing the comment itself.
- Talk it out – discuss the potential impact on yourself and others as well as your own personal perception of the comment.
However, Dr. Brian Williams, an associate professor of trauma and acute care surgery at the University of Chicago, asserts during the ACS webinars that “It is not your job to make those around you comfortable.”
For the perpetrator, they may not be aware that their words or behaviors are offensive in the first place and may not know how to respond when accused of microaggressions in the workplace.
Recognizing that microaggressions can be subtle and unintentionally hostile or derogatory, Derald Wing Sue, a professor of psychology and education at Columbia University, created a taxonomy of common racial microaggressions that occur in everyday life through a review of psychological literature. He identified three prevalent types of microaggressions:
- Microassaults – explicit racial derogatory verbal or not verbal attacks that are meant to intentionally hurt the victim. This can include the use of racial slurs or symbols.
- Microinsult – comments that are rude, insensitive, and/or demeaning in nature. For example, asking a colleague of color how they got their job, which implies that they may have only gotten it due to their race or an affirmative action system.
- Microinvalidations – comments or actions that exclude or dismiss the thoughts, feelings, or reality of people of color. One is example is the phrase “I don’t see color.” While this may be intended as a way to express one’s desire towards inclusiveness, it is dismissive of the true reality and experience of people of color.
Similarly, Dr. VJ Periyakoil, a professor of medicine and associate dean of research of Geriatrics and Palliative Care at Stanford University, identified six common types of microaggressions in the workplace reported by female medical faculty from four universities:
- Those related to sexism
- Sexually inappropriate comments
- Pregnancy and childcare bias
- Having one’s abilities underestimated
- Being relegated to mundane tasks
- Feeling excluded and marginalized
How, then, can you respond to accusations of microaggressions, even if the offensive nature of your comments or actions wasn’t intentional?
Experts suggests apologizing “immediately and sincerely” and caution against acting offended by the allegation, even if your intentions were good. Lastly, consider this transgression as a teaching moment for yourself, try to learn from your mistakes and strive to do better in the future.
How to be an ally in the workplace
If you become aware of microaggressions among your colleagues, how can you become an ally, both as an individual and within your organization?
In their 2018 report titled “Beyond Silence and Inaction: Changing the Response to Experiences of Racism in the Healthcare Workforce,” Premkumar et al. suggest that hospital faculty use real-life or improvised encounters to determine potential responses to microaggressions, implement implicit bias education programs in order to identify their own biases and improve patient-provider interactions, and establish a chain of command so that faculty know who to contact if they need to report an occurrence.
Allyship, they note, is “no longer a luxury, but a requisite component of working and training in health care.”
Researchers at the University of Toronto agree. As a part of their Faculty of Medicine Office of Inclusion and Diversity’s Microaggressions and Allyship Campaign, they seek to encourage and raise awareness of allyship through the CARES acronym:
- Consider how what one said was harmful
- Be accountable for your actions and willing to apologize
- Rethink harmful assumptions or stereotypes
- Empathize with those on the receiving end of microaggressions
- Support by offering resources and asking how you can help
They suggest that allies should be willing to be aware of their own prejudices, avoid making assumptions about a person based on their appearance, and speak up when they hear offensive comments or jokes.
To read more of their tips for how to be an ally in the workplace, click here.
The Prevalence of Microaggressions Among Surgeons
In their 2021 study published in JAMA Surgery, Sudol et al. sought to identify the prevalence and severity of sexist and racial/ethnic microaggressions against female and minority surgeons as well as determine any associations between microaggressions and burnout.
Conducting a cross-sectional survey of all surgeons from Southern California Permanente Medical Group between January and February 2020, they found that a significant number of both racial/ethnic minority and female surgeons reported experiencing some type of microaggressions.
Nearly half of participants reported experiencing burnout, and burnout was higher among females and racial/ethnic minorities, especially those who also experienced microaggressions.
Their findings, the study authors believe, acknowledge the gaps in compassion and empathy within the medical community as a whole.