Impact of race on the professional lives of physicians of African descent.
BACKGROUND: Increasing the racial and ethnic diversity of the physician workforce is a national priority. However, insight into the professional experiences of minority physicians is limited. This knowledge is fundamental to developing effective strategies to recruit, retain, and support a diverse physician workforce. OBJECTIVE: To characterize how physicians of African descent experience race in the workplace. DESIGN: Qualitative study based on in-person and in-depth racially concordant interviews using a standard discussion guide. SETTING: The 6 New England states in the United States. PARTICIPANTS: 25 practicing physicians of African descent representing a diverse range of primary practice settings, specialties, and ages. MEASUREMENTS: Professional experiences of physicians of African descent. RESULTS: 1) Awareness of race permeates the experience of physicians of African descent in the health care workplace; 2) race-related experiences shape interpersonal interactions and define the institutional climate; 3) responses to perceived racism at work vary along a spectrum from minimization to confrontation; 4) the health care workplace is often silent on issues of race; and 5) collective race-related experiences can result in "racial fatigue," with personal and professional consequences for physicians. LIMITATIONS: The study was restricted to New England and may not reflect the experiences of physicians in other geographic regions. The findings are meant to be hypothesis-generating and require additional follow-up studies. CONCLUSIONS: The issue of race remains a pervasive influence in the work lives of physicians of African descent. Without sufficient attention to the specific ways in which race shapes physicians' work experiences, health care organizations are unlikely to create environments that successfully foster and sustain a diverse physician workforce.