A few months ago, I was on call as a cardiology fellow, and I had to go up to one of the inpatient floors to do a stat echocardiogram on a patient. Given how hemodynamically unstable he was, I was rushing to the room as fast as I could with this hefty machine that could give important information about cardiac function in seconds. One of my responsibilities at that time was to perform these echocardiograms at a moment’s notice after hours. I finally arrived in the room, out of breath with my heart pounding as I tried to maneuver the machine into the room. As I was entering the room, the nurse outside told one of her colleagues, “Hooray, the echo tech is here!” The funny (or not so funny) thing was that I was wearing my white coat with the M.D. after my last name in big letters. I could have said something, but in the midst of the chaos, I just went about and did my thing. As I left, she asked me how I got there so fast, and I told her that cardiology fellows had to do stat echocardiograms after hours. As I was walking away with the machine, I caught a brief look of surprise on her face as she realized the actual role I had in the hospital.
I tell this story to highlight the fact that in certain situations over the past few years, some people have assumed that my job in the hospital is different than being an actual, licensed physician. You probably guessed by looking at my name that I am of African descent, and you would be correct. I am the son of Nigerian immigrants, and with their love and support, I became the first physician in my family. With that, I became part of a small group of black male physicians that make up the physician workforce, a group that based on a recent article1 is slowly diminishing. I have had the MD after my last name for the past five years, and during that time, I have talked to other colleagues from minority groups about their experiences of how they are perceived in the hospital. Unfortunately, I have heard countless stories of them being mistaken for transport staff, technicians and cooks (even while they were wearing their white coats), and I wish I can say that I have escaped those experiences, but they have happened to me as well.
What hurts about these experiences is that in a way, it diminishes the sacrifice of time and effort we have given to become doctors. There is nothing wrong with those prior professions I mentioned, and for people in those professions, there are particular skills sets they use from which we all benefit. However, many of the people in those professions come from the same racial group as me, and on a day-to-day basis, the numbers of physicians that I see who look like me are few and far between. The public sees this as well, and so it is not surprising that some people assume that if I look a certain way, I probably fit in one of these aforementioned professions. The likelihood of me being a doctor is not as high in terms of possible career paths for me in their minds, despite the four years of medical school and three years of residency that I have gone through, or the MD after my name.
And minorities are not the only people who deal with this issue. I have also heard of many of my female colleagues being mistaken as nurses or other ancillary staff when in fact they are full-fledged attendings who are the leading people in their fields. Two years ago, Dr. Lemay wrote a thought-provoking article2 that touched on how she dealt with these assumptions from other patients. She highlighted beautifully the fact that there are differences in skill sets between doctors and nurses, and how crucial they are to the well-being of patients, but that at the end of the day, she was still a doctor that deserved to be acknowledged as such given the hard work she put into becoming one.
At the end of the day, physicians from certain groups are intermittently dealing with the problem of perception. Whether it is based on outside interactions that people may have had or things that are seen in the media, there seems to be a lag in terms of how quickly we are identified as doctors if we look a particular way. For some people, we are sooner perceived as part of ancillary staff than as physicians, and in those situations, we are forced to (gently) remind people of the sacrifice we have made in order to bear the MD after our names. Hopefully, with increased representation of minorities and females in medicine, these stories will become less of a reality for many of us over time.
Chiduzie Madubata is a cardiology fellow.
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