Program Director’s Corner – April 2021
Implementing Anti-discrimination Policies
Rana Malek, MD
Program Director, Endocrinology, Diabetes, and Metabolism Fellowship
University of Maryland School of Medicine
On March 16, 2021, 8 people were murdered in a mass shooting that took place in several Atlanta based massage parlors. Six of the eight victims were women of Asian descent. This incident is one more violent example of rising anti-Asian sentiment in the United States.
The rise in hate incidents against Asian-Americans began with the emergence of the COVID-19 pandemic in the United States. According to reports from the Asian Pacific Policy and Planning Council, from 3/19/20 to 5/13/20, more than 1700 anti-Asian hate incidents were documented in the U.S. However, anti-Asian sentiment is not a new phenomenon and was formalized by the Chinese Exclusion Act of 1882 which suspended Chinese immigration for 10 years and made Chinese immigrants ineligible for naturalization. Sixty years later, President Franklin Roosevelt signed Executive Order 9066 which forced the relocation of Japanese-Americans, the majority of whom were U.S. citizens, to internment camps.
As program directors we have had to navigate numerous crises over the past year. We have worked to keep our trainees and colleagues safe in the setting of COVID-19. We have stood in solidarity during Black Lives Matter protests during the summer. We again stand in solidarity with Asian-Americans and condemn racism.
We need to be more proactive in protecting our trainees, colleagues, and hospital staff from discrimination that they may face. Many providers have experienced discriminatory behavior from patients who refuse to be seen by female, non-Christian, or non-white physicians. Providers who have faced this discrimination have felt unprepared for how to handle it, or worse, when it happens to trainees, the trainee may feel abandoned by the system.
The clinical learning environment can play a role in supporting its staff from discrimination. An excellent model comes from Johns Hopkins Medicine’s Office of Diversity, Inclusion, and Health Equity. In March 2020, they launched the “Prohibiting Discrimination by Patients Against Employees” policy. In it, they affirm a patient’s right to be an active participant in their treatment, while also reaffirming their commitment to protect their faculty, staff, and trainees from discrimination by patients and/or health care decision makers
As we think about how to go beyond expression of solidarity, implementing anti-discrimination policies is a concrete example of change we can make as programs directors. Reviewing this thoughtful approach made me reach out to my own GME office to consider establishing a similar hospital wide policy. Having a hospital wide approach means that all staff, not just faculty and trainees but also our nurses, medical assistants, and supporting patient care staff share equal protection. This is one step we can take in our institutions to implement meaningful benefit to our colleagues that work so hard to deliver quality healthcare.
Dr. Rana Malek is a current member of the APDEM Council.