Toxic Work Culture in Medicine

Will Telemedicine be your Safe Space from Microaggressions?

In every industry sector, we face challenges that can make our work environment quite unpleasant and give rise to a toxic work culture. These difficulties may be technology, workflow, or coworker-related. The medical industry is no different. As medical professionals, some of us experience what is known as microaggressions.

According to the Oxford dictionary, microaggression is described as an act, incident, or statement observed as a case of unintentional or implied discrimination toward persons from an ethnic or racial minority and other marginalized groups. In this article we will discuss the opportunity that telemedicine may provide to empower the healthcare professional.

This toxic culture is displayed in some very simple ways, such as constantly referring to a female coworker as a nurse, although it is common knowledge that she is a doctor. Extreme examples may border on overt racial or sexual harassment in the healthcare workplace.

Due to the complex entrenched power dynamic of senior physicians, many minority and/or female staff may feel hesitant to report a negative work experience.

The COVID-19 pandemic has undoubtedly caused tremendous global chaos. However, it has brought innovation and many other changes to the medical industry.

Patients and providers alike are more at ease in the digital space, as a respite from the complexities of the real world. It can be argued that greater inclusive access to affordable consumer digital products i.e. smartphones and wireless internet connectivity, may be a step forward towards democratised medical experiences.

Although it is not a new concept, telemedicine is one of those changes induced by the pandemic, and it has grown to become the go-to solution for many healthcare institutions.

With the increased use of telemedicine, many wonder if it will provide a safe haven from microaggressions.

Telemedicine May Combat the Three Categories of Microaggressions

Microassaults, microinsults, and microinvalidations are the three primary microaggression categories. Microassaults are conscious acts or thoughts that can be biased or discriminatory verbal abuse or behaviors.

For example, someone tells a racist joke, then says, “I was just joking.” Next, there are microinsults. These are usually unconscious messages regarded as disparaging and insensitive to one’s racial identity or background.

A growing body of research indicates that microaggressions can seriously harm patient care by making important communication impossible and turning people off entirely from getting medical care. Patients report feeling marginalized in a variety of ways.

“What they do is make patients feel marginalized,” said Georges Benjamin, executive director of the American Public Health Association. “Some [microaggressions] are more overt – people assume you’re having less pain than you actually are or you’re going to abuse pain medications so they give you just enough for the weekend.”

Lastly are microinvalidations, which are behaviors and statements, meant to exclude, negate, and dismiss an individual’s feelings, thoughts, and experiences. Within the medical field, this could be attributed to promotions, etc.

Through the reduction of face-to-face interaction, many marginalized groups are no longer subjected to particular aspects of microinsults, microassaults, and microinvalidations, along with the toxic culture they beget within the workplace.

Considering that working remotely, in most cases, reduces unnecessary interaction, a lot of persons do not have to communicate, for example, in the breakroom or elevator. Numerous microaggression experiences occur in these areas.

In some instances, microaggressions are evident in bulletins posted on general notice boards, whereas with a work-from-home setup, it’s likely that the email notices we receive are specific to our teams and are less likely to be offensive.

Telemedicine Combats Gender-specific Microaggression

One study carried out by Dr. VJ Periyakoil indicated that microaggressions are promoting the rapid migration of female doctors (a minority group) from the medical field. Their departure is linked to many forms of microaggressions, including inappropriate sexual comments and being relegated to mundane tasks.

Telemedicine is now affording female doctors the opportunity to work from home. As such, there undoubtedly will be fewer occurrences of sexual inappropriateness, and to some extent, a change in assigned tasks.

With the ability to place a geographic distance from hostile patients or even control the interaction (placing yourself on mute or with the camera off) it is possible to empower the provider to maintain their professional dignity.

Additionally the ability to record a telehealth session/meeting is a powerful tool to keep inadmissible evidence of an adverse encounter (even from a superior or a high net worth patient)

CONCLUSION

It is possible that telemedicine can provide a safe space from certain conscious or unconscious biases. While it may not be all-encompassing, telemedicine has definitely softened the blow of microaggressions that affect our access to opportunities and resources and fosters a toxic culture within the work environment.

Having a virtual practice under full control of the provider, may empower individuals to take better control of their career choices, earn a sustainable income and still actively contribute to the community in need, away from toxicity and internal politics of a health system under great stress.

Are you looking for this career freedom as well?

Why not start your own virtual clinic, in our global health platform

• No toxicity
• No Microaggressions
• Total autonomy in the digital health space

References 

‌Ehie, O., Muse, I., Hill, L., & Bastien, A. (2021). Professionalism: microaggression in the healthcare setting. Current Opinion in Anaesthesiology, 34(2), 131–136. https://doi.org/10.1097/aco.0000000000000966

Smith, A. (2020, June 12). What to know about microaggressions. Medicalnewstoday.com; Medical News Today. https://www.medicalnewstoday.com/articles/microagressions

‌Torres, M. B., Salles, A., & Cochran, A. (2019). Recognizing and Reacting to Microaggressions in Medicine and Surgery. JAMA Surgery, 154(9), 868. https://doi.org/10.1001/jamasurg.2019.1648

‌White, T. (2019, November). Microaggressions common in the medical workplace, Stanford study suggests – Scope. Scope. https://scopeblog.stanford.edu/2019/10/31/microaggressions-common-in-the-medical-workplace-stanford-study-suggests/

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