Female physicians far more likely to experience microaggressions from patients

Key takeaways

• A recent study found that female physicians experience microaggressions from patients more often than male physicians (P < .001).
• The most common microaggressions reported by female physician respondents relate to role questioning, including patients assuming they are not physicians, expressing surprise at their role as the physician, and assuming their expertise to be inferior.
• Gendered microaggressions were associated with burnout (P = .003), behavioral modifications (P < .001) and job satisfaction (P = .009).

Female physicians experience more microaggressions from patients than male physicians, which can influence job satisfaction, burnout and behavioral modifications, a recent study found.

Speaking to Healio, lead author Sarah Ahmad, MD, an assistant clinical professor in the department of neurology at the University of California, San Francisco, said that she and her colleagues have firsthand experiences with microaggressions from patients.

“When I speak to patients, even if I introduce myself as the doctor, [they] call me by my first name, or they’ll ask when the doctor is coming in, or they'll refer to me as a nurse,” Ahmad said.

Ahmad and colleagues conducted a mixed-methods survey-based study to try “to understand if this phenomenon represented a broader pattern of behavior,” she said.

“We thought it would be interesting to take this a step further rather than just sharing anecdotes to see if this is actually something we can describe from a scientific standpoint,” Ahmad said. “Is this a pattern? Do other people experience this?”

The study was conducted at a single academic health care institution in May 2019. The researchers divided microaggressions into four themes within the survey: sexual objectification, use of sexist language, assumptions of inferiority and assumptions of traditional gender roles.

The findings were published as an abstract at the Women in Medicine Summit, with the full manuscript published in the Journal of Women’s Health.

Results from 297 completed surveys showed that female physicians experienced microaggressions more often than male physicians (P < .001), while trainees experienced a higher rate of microaggressions than faculty (P < .009).

A vast majority of female physicians (79%; n = 289) reported an experience in which a patient assumed that they were not a physician. This was the highest-reported incident by female respondents, according to the researchers.

Other microaggressions commonly experienced by female physicians included patients being surprised by their role (66%; n = 290) and patients assuming their expertise to be inferior (59%; n = 284).

Ahmad and colleagues also reported gendered microaggressions were associated with:

• job satisfaction (P = .009);

• perceived career impacts (P < .001);

• burnout (P = .003); and

• behavioral modifications (P < .001).

The researchers found that female physicians often change their behavior in response to microaggressions from patients. More than half (53%) of female respondents (n = 289) agreed or strongly agreed they do.

“We may end up spending more time with the patient. We might work harder or dress differently, to gain that respect,” Ahmad said.

According to Ahmad, one of the most significant takeaways from the study was finding evidence that helps to validate physician experiences with gendered microaggressions.

“The issue with microaggressions is that they are often so subtle that it will call into question, or cause you to doubt your experience,” she said, emphasizing they can be more harmful than outright macroaggressions due to that questioning, the frequency of which they happen, and them having “an additive effect.”

References:

• Ahmad S. Are you really the doctor? Physician experiences with gendered microaggressions from patients. Presented at: Women in Medicine Summit; Sept. 16-17, 2022; Chicago.
• Ahmad S, et al. J Womens Health. 2022;doi:10.1089/jwh.2021.0169.