Black physicians are tired of paying the minority tax


Here’s a controversial phrase for a doctor to say that needs to be normalized: “I am tired.”

As a physician, working oneself to exhaustion for our patients is often seen as a sign of strength and even heroic.  As a rare Black male in medicine in the midst of a pandemic that is ravaging patients who look like me, I am especially battle fatigued.  In fact, I am traumatized, as I have had to reckon with the revelation that I often do not feel true safety.  Safe in the sense that I cannot fully trust that I can bring my true, authentic self and racialized experiences to all workspaces without risk of judgment or retribution unless they show keen understanding and sensitivity.

This has been especially apparent over the last year when many institutions have been challenged to grapple with the reality and troubling pattern of senseless losses of numerous Black bodies, including George Floyd, Breonna Taylor, and Alton Sterling.  Every day, I’m pulled in a variety of directions, with a strained schedule for patients who specifically want to see a Black physician who won’t “Tuskegee” them and will understand their issues.  Additionally, it is often put on the backs of Black and Latinx communities to shoulder or spearhead diversity, equality, and inclusion efforts on top of balancing the many basic work responsibilities we are already obligated to do, what has often been referred to as the “minority tax.”  Efforts done by few that ultimately help to make our entire institution better.

This “minority tax” on my professional self leaves me wrestling with a mixture of hyper-exposure and also painful invisibility.  I’ve experienced over-exposure in the sense that I am frequently sought out by students of color and leadership for my thoughts on how to survive and thrive as a person of color in academia, a matter of great importance to me that deeply informs the work that I do.  However, I also frequently feel the sting of invisibility, sometimes mistaken for hired help while walking the hospital wards instead of as a skilled primary care physician. Always, I am frustrated that I am one of the few Black physicians where I work.

Sadly, this experience is true and common throughout academic medicine where Black men make up less than 3 percent of physicians, something that requires immediate action to correct the systemic barriers against minorities pursuing a medical career.

This lack of representation in academic medicine has very real consequences in our public health care sector, shaping disparities in the care that minority populations receive.  Ramifications for this can even be seen in the midst of the COVID-19 pandemic, with jarring statistics showing that Black and Latinx populations are hit the hardest and are dying at a higher rate in our country.  Aside from COVID-19, Black Americans have some of the worst health outcomes of any racial group in the nation. Black men have the shortest life expectancies. Black women fare the worst in pregnancy.  More Black babies die than any other race.

As the COVID-19 pandemic rages on, there are many decisions that lay in front of us with full acknowledgment that health care disparities will still exist even once the pandemic is over.  How our health care system actionably supports its minority physicians and increases this workforce will have an everlasting impact on how we rebound to provide the quality care our already-hurting communities desperately need.

As I have navigated my career, I’ve had to create community where I seemingly couldn’t find it, but imagine not having to do this in the first place.  I long for the day where I can see the house that systemic racism has built to be fully dismantled, and for a day where things are fair and just, and where I can put down the façade of being “OK,” and be more vulnerable, and not have to be the “unicorn” in patient care spaces and academia.

Strategies to create safe spaces for battle-fatigued minority faculty physicians are paramount. Many of us are silently suffering under the weight put upon us to be everything to everyone.  We constantly give our very best to our institutions.  It is time for the medical system to show that same radical heroics, intentionality, empathy, and strategy for those taxed the most.  These efforts involve cultural and structural change and cannot be performative or done only when it seems en vogue. It will require dismantling systemic inequity within organizations so that everyone has the opportunities and resources necessary to thrive. I also long for a day where having someone like me in academic spaces isn’t seen in bewilderment but is ultimately normalized and seen with pride.  Our current and future patients, students, and communities need and deserve this.

Carl Earl Lambert, Jr. is a family physician.

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