Is Academic Anesthesia Diverse, Equitable and Inclusive?

Hana Nadeem

Renee Navarro, MD, PharmD, from University of California, San Francisco, put the spotlight on the different kinds of discriminations currently experienced in academic medicine and anesthesia in the “Leadership Advisory Board Panel II: Addressing Discrimination in the Workplace,” on May 13 at the AUA 2021 Annual Meeting, moderated by Mohammed Minhaj, MD. The goal of her presentation was to better understand the impact of unconscious bias on diversity, equity and inclusion (DEI), as well as learning new tools that facilitate the implementation of these factors in work environments.

Medicine has a long issue with racism, discrimination and inequity, Dr. Navarro explains. Looking at US medical school graduates, faculty and applicants by race and ethnicity in the past couple of years, the results were consistent, showing a higher percentage of white individuals compared to Blacks, Hispanics, Asians and more. After defining diversity as a “variety of personal experiences, values and worldwide views that arise from differences of culture and circumstances like race and ethnicity,” Dr. Navarro mentioned that a lack of diversity and equity in a workplace has a negative impact on patients and staff. It is important to find the initiative to adopt these concepts and create a climate of inclusion in academic medicine and anesthesia in order to increase competence in patient care and have a “better science.”

For the past century, structural and interpersonal racism has reflected on how people interact with each other, which has led to the reinforcement of what’s called “unconscious bias.” It consists of developing stereotypes with a potential to influence the behavior, judgment and clinical care among healthcare professionals. To support this idea, Dr. Navarro presented a few examples of this bias in patient care, referring to the Tuskegee experiment. She shared articles discussing racial disparities in pain management of black vs white children and the false belief adopted by many individuals about biological differences. Results showed that a black child is less likely to receive opioids due to the stereotype that having black skin makes the individual feel less pain. Leading to a less accurate treatment recommendation, unconscious and racial bias must be eliminated.

How do we dismantle systemic racism and how can we improve the workplace environment? This can be achieved on different aspects, Dr. Navarro explained. On an individual aspect, it is crucial to learn about our own unconscious bias, educate and train ourselves to be inclusive of people, but most importantly mentor individuals from groups underrepresented in anesthesiology in order to broaden our mindset and demolish our false ideations. On an institutional aspect, interrupting the bias can be accomplished by providing training workshops, clear the expectations, increase access to opportunities for development and advancement, and build a diverse faculty. Reaching this level of inclusivity, equity and diversity can lead to better education and patient care within the profession of anesthesia.