Survey for health care workers: Have you ever encountered macro or microaggressions?

The results will be used to create a handbook on how to navigate such scenarios

Key takeaways:

• Physicians are collecting survey responses to create a resource on how to handle discrimination.
• The survey is open until the end of May.

Physicians have created a survey for health care workers to assess experiences with microaggressions, sexism, racism and other forms of discrimination at work, school, in patient environments or during interactions with patients’ families.

The survey, led by Shikha Jain, MD, FACP, an associate professor of medicine with tenure in the division of hematology, oncology and cell therapy at the University of Illinois Cancer Center in Chicago, and Janice Werbinski, MD, FACOG, FAMWA, NCMP, a board-certified OB/GYN, outgoing president of the American Medical Women's Association and Associate Clinical Professor Emerita at Western Michigan University Homer Stryker School of Medicine, will be used to publish a handbook of comebacks to counter these interactions in the future.

“Our goal is to get a qualitative idea of different types of bullying, microaggressions, racism, sexism — all of the ‘isms’ — and then share how other people have handled it and best practices for handling those situations,” Jain, who is also a consulting editor for Healio’s Women in Oncology and host of Healio's Oncology Overdrive podcast, said in an interview. “By putting this information out into the world in the format of a handbook, we’re hoping it will allow other people to combat these issues, whether it’s to themselves or to other people.”

Werbinski said that, with the exception of racism and homophobia, she has experienced “all of the forms of sexism, macroaggression, microaggression and disparities in pay, promotion and credibility that will be described in this handbook.”

“Since medical school, I have wished that someone would write a book like this,” she said.

Werbinski described an example of overt sexism in the workplace that she said “had a negative effect” on her career. For 15 years, she served as the medical director of a women’s medical center. After the hospital merged three OB/GYN practices, the leaders of each clinic were trying to decide who would be on call during the nights — a complication since several of the physicians did not deliver babies.

A male physician said during the meeting that his team would cover for one physician — another man — for free, but that Werbinski needed to pay $100 for every time they covered her.

“There were two women in his practice and they both disagreed,” Werbinski said. “That’s when I went to the CEO of the hospital and said he needed to intervene, but he wouldn’t ... so I quit.”

A handbook to help physicians navigate these situations would have been useful, she added.

Shikha Jain, MD, FACP

Jain and Werbinski conceptualized the idea of creating a handbook following a lecture at the 2022 Women in Medicine Summit.

“One of our keynote speakers was unable to make it due to a family emergency, so I stepped in last minute and gave an impromptu lecture with a town hall-type discussion afterwards talking about bullying and microaggressions and how to address those in the workforce and why it’s such a big issue,” said Jain, the chair and founder of the Women in Medicine Summit and president of the nonprofit Women in Medicine. “Dr. Werbinski stood up to the microphone and said, ‘this is a fantastic discussion and primer on bullying and microaggressions. How would you feel about turning this into a handbook?’ And I said, ‘let’s do it.’”

While creating the survey, Werbinski said her “eyes were opened to the myriad of situations and diversity of people who are affected.”

“The bottom line here is that implicit bias and these types of aggressions result from an unequal distribution of power, so in concert with learning comebacks and upstander techniques, we need to develop a way to impart consequences when people in power overstep, and a way to educate all in these concepts,” Werbinski said.

Werbinski said that she hopes the survey will spread “appreciation and acknowledgment of the issue” and the awareness that anyone can be a defender rather than just a bystander when they witness microaggressions. She also hopes it offers validation for victims that they are not over-sensitive “and that their self-worth and self-confidence should not be sacrificed or suppressed.”

Most notably, though, she hopes the survey offers knowledge that could help people navigate similar situations, something she always wished she had.

“I have never discussed an event with a friend or colleague who hadn’t thought of a comeback after the fact,” she said. “It has been shown that when someone is experiencing bias or aggression, the adrenalin ‘fight or flight’ mechanism kicks in, and speech, thinking, and retorts can be incapacitated. I hope that this book will give people the tools and confidence they need when faced with these situations.”

Jain added that these toolkits need to be created for those in health care and beyond, because bias is not exclusive to one field.

“There are toxic work environments everywhere,” Jain said. “I’m hopeful that by creating this toolkit, we’re able to provide some resources for women, men, people who are transgender and all of the people out there who have ever been in a situation that’s been uncomfortable or awkward or just flat out bullying to really understand how they can navigate that situation.”

The survey will be open until the end of May. To participate, click here.

References:

• Survey: Comebacks for those who experience microaggressions. https://redcap.link/v3suvco3. Accessed April 22, 2023.
• Who's really the victim here? — It’s time to end DARVO behavior in the healthcare workplace. https://shikhajainmd.com/2022/06/08/whos-really-the-victim-here-its-time-to-end-darvo-behavior-in-the-healthcare-workplace/. Published June 8, 2022. Accessed April 22, 2023.